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• W2122350594 abstract "Whether good diabetic control prevents or delays the onset of diabetic complications has been debated since the first clinical use ofinsulin in 1922. The recently published Diabetes Control and Complications Trial (DCCT)' shows that it does. Patients with insulin-dependent diabetes (IDDM) who had no complications (primary prevention group, n = 726) or minor retinopathy (secondary prevention group, n = 715) were randomized to receive 'intensified' or 'conventional' insulin therapy. The trial was halted after a mean of 6.5 years when it was clearly shown that intensive therapy (resulting in a mean blood glucose of 8.6 mmol/l versus 12.8 mmol/l in the conventional group) reduced the risk of development and progression of diabetic retinopathy by 54-76%, microalbuminuria by 39-54% and neuropathy by 60%. The results are similar to those of smaller but equally persuasive studies such as the Stockholm Diabetes Intervention Study2 and provide conclusive evidence of a link between high blood glucose concentrations and microvascular complications (retinopathy, nephropathy and neuropathy). As a result of the DCCT, the American and British Diabetic Associations recommend that a primary treatment objective in IDDM should be blood glucose control at least equal to that achieved in the intensively treated group of the DCCT.3'4 How this is to be achieved in ordinary practice is the question confronting diabetologists." @default.
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• W2122350594 date "1994-10-01" @default.
• W2122350594 modified "2023-10-13" @default.
• W2122350594 title "How to achieve optimal diabetic control in patients with insulin-dependent diabetes" @default.
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• W2122350594 doi "https://doi.org/10.1136/pgmj.70.828.675" @default.
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