Effect of intensive diabetes treatment on the development and progression of long-term complications in adolescents with insulin-dependent diabetes mellitus: Diabetes Control and Complications Trial☆,☆☆,★,★★
Section snippets
Subjects
A total of 195 adolescent subjects (125 primary prevention and 70 secondary intervention cohort) were recruited by 29 clinical centers from 1983 to 1989.2 At the time of study termination, in June 1993, the adolescent subjects had been studied for an average of 7.4 years (range, 4 to 9 years). The results reported here include the outcomes in the subjects who were adolescents at the time of study entry, independent of whether they were adolescents during the entire study. The subjects in this
Adherence and metabolic control achieved
One hundred ninety-five adolescent subjects were followed for a mean of 7.4 years (range, 4 to 9 years), for a total of more than 1448 patient-years. None of the adolescent subjects voluntarily withdrew from the study, and more than 95% of all scheduled examinations were completed. Two subjects died and two were assigned to inactive status for some time because of unavailability or the investigator's decision that continuation would be hazardous. Overall, the average percentage of time spent in
DISCUSSION
We undertook an analysis of outcome in adolescent subjects with IDDM because none of the previous randomized clinical trials of intensive therapy included young subjects, even though the majority of subjects with IDDM have their onset before age 20 years. Thus the demonstration that intensive therapy with the goal of lowering plasma glucose concentrations delays the onset and slows the progression of early diabetic retinopathy (the principal study outcome) in adolescents with IDDM is especially
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Supported by the Division of Diabetes, Endocrinology, and Metabolic Diseases of the National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, through cooperative agreements and a research contract. Additional support provided by the National Heart, Lung, and Blood Institute, the National Eye Institute, and the National Center for Research Resources.
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Reprint requests: Diabetes Control and Complications Trial Research Group, Box NDIC/DCCT, Bethesda, MD 20892.
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See commentary, Reviewing the Diabetes Control and Complications Trial: One member of the "control panel" speaks