The benefits of intensive blood sugar control last for years, according to a national consortium of researchers in a study published in the New England Journal of Medicine (2000;342:381–389).
A study of patients with type 1 diabetes who participated in the Diabetes Control and Complications Trial showed that those who worked hard (intensive treatment) to control their blood sugar had fewer problems with diabetic retinopathy, neuropathy, and related kidney disease than those who used less intensive blood sugar management. The multicenter study of 1441 people with type 1 diabetes compared intensive treatment with conventional treatment. Patients on intensive treatment kept glucose levels as close to normal as possible with ≥3 insulin injections a day or an insulin pump and frequent self-monitoring of blood glucose. Conventional treatment consisted of 1 or 2 insulin injections a day, with once-a-day urine or blood glucose testing. As expected, those who practiced the intensive management kept their blood sugar closer to normal than those who received conventional treatment. After the study, the conventional group received training in maintaining good blood sugar control and were encouraged to follow that plan. Researchers continued to follow the 2 groups.
The striking new finding is that people who received intensive therapy during the study continued to have a lower risk of eye and kidney disease than those who had been on conventional treatment 4 years after the study ended and both groups went on intensive treatment. “Intensive management, with the aim of keeping blood glucose levels as close to normal as possible, is extremely effective at reducing the complications of diabetes,” said David Nathan, MD, of Massachusetts General Hospital, who co-chaired the research group. “Now we know that the benefits of intensive control continue for years.”
About 16 million people in the United States have diabetes, which is the most common cause of blindness, kidney failure, and amputations in adults. About 10 percent, or 1.6 million, have type 1 diabetes.
- Copyright © 2000 by American Heart Association