Effect of intensive diabetes management on macrovascular events and risk factors in the Diabetes Control and Complications Trial - PubMed (original) (raw)
Clinical Trial
Effect of intensive diabetes management on macrovascular events and risk factors in the Diabetes Control and Complications Trial
No authors listed. Am J Cardiol. 1995.
Abstract
The Diabetes Control and Complications Trial (DCCT), a multicenter, randomized, controlled clinical trial, demonstrated that intensive diabetes therapy delays the onset and slows the progression of retinopathy, nephropathy, and neuropathy in patients with insulin-dependent diabetes mellitus. This study presents the effect of intensive therapy on atherosclerosis-related events and associated risk factors. Patients (n = 1,441) between the ages of 13 and 39 years with insulin-dependent diabetes mellitus were randomly assigned to conventional or intensive diabetes treatment. The patients were free of cardiovascular disease at baseline. Patients with hypertension, hypercholesterolemia, or obesity were excluded. Average length of follow-up was 6.5 years (range 3.5 to 9). The study used standardized definitions of macrovascular events, verification of such events, and central laboratories for determination of lipids and the grading of electrocardiograms. The number of combined major macrovascular events was almost twice as high in the conventionally treated group (40 events) as in the intensive-treatment group (23 events), although the differences were not statistically significant (p = 0.08). There were no differences in the cumulative incidence of hypertension. Mean total serum cholesterol, calculated low-density lipoprotein cholesterol, and triglycerides were significantly reduced in the intensive-treatment group (p < or = 0.01), as was the development of low-density lipoprotein cholesterol levels > 160 mg/dl. Weight gain was significantly increased in the intensive-treatment group (p < 0.001). There were no differences in cigarette smoking habits, consumption of alcohol, or aspirin use between treatment groups. The reduction in some, but not all, cardiovascular risk factors suggests a potential beneficial effect of intensive therapy on macrovascular disease in insulin-dependent diabetes mellitus.
Similar articles
- Exogenous insulin administration and cardiovascular risk in non-insulin-dependent and insulin-dependent diabetes mellitus.
Genuth S. Genuth S. Ann Intern Med. 1996 Jan 1;124(1 Pt 2):104-9. doi: 10.7326/0003-4819-124-1_part_2-199601011-00005. Ann Intern Med. 1996. PMID: 8554200 - Effect of intensive glycemic control on levels of markers of inflammation in type 1 diabetes mellitus in the diabetes control and complications trial.
Schaumberg DA, Glynn RJ, Jenkins AJ, Lyons TJ, Rifai N, Manson JE, Ridker PM, Nathan DM. Schaumberg DA, et al. Circulation. 2005 May 17;111(19):2446-53. doi: 10.1161/01.CIR.0000165064.31505.3B. Epub 2005 May 2. Circulation. 2005. PMID: 15867184 Clinical Trial. - Epidemiology of Diabetes Interventions and Complications (EDIC). Design, implementation, and preliminary results of a long-term follow-up of the Diabetes Control and Complications Trial cohort.
Epidemiology of Diabetes Interventions and Complications (EDIC) Research Group. Epidemiology of Diabetes Interventions and Complications (EDIC) Research Group. Diabetes Care. 1999 Jan;22(1):99-111. doi: 10.2337/diacare.22.1.99. Diabetes Care. 1999. PMID: 10333910 Free PMC article. - Hypertension and macrovascular disease--the killing fields of NIDDM.
Laakso M. Laakso M. Diabetes Res Clin Pract. 1998 Apr;39 Suppl:S27-33. doi: 10.1016/s0168-8227(98)00020-5. Diabetes Res Clin Pract. 1998. PMID: 9649957 Review. - Issues surrounding tight glycemic control in people with type 2 diabetes mellitus.
Cerveny JD, Leder RD, Weart CW. Cerveny JD, et al. Ann Pharmacother. 1998 Sep;32(9):896-905. doi: 10.1345/aph.17375. Ann Pharmacother. 1998. PMID: 9762378 Review.
Cited by
- The double burden: type 1 diabetes and heart failure-a comprehensive review.
Julián MT, Pérez-Montes de Oca A, Julve J, Alonso N. Julián MT, et al. Cardiovasc Diabetol. 2024 Feb 12;23(1):65. doi: 10.1186/s12933-024-02136-y. Cardiovasc Diabetol. 2024. PMID: 38347569 Free PMC article. Review. - The Effect of Glycemic Control on Left Ventricular Function in Clinical and Experimental Diabetes.
Lavine SJ, Prcevski P. Lavine SJ, et al. CJC Open. 2023 Jul 7;5(10):728-738. doi: 10.1016/j.cjco.2023.06.007. eCollection 2023 Oct. CJC Open. 2023. PMID: 37876883 Free PMC article. - Sex and Racial Disparities in Peripheral Artery Disease.
Divakaran S, Krawisz AK, Secemsky EA, Kant S. Divakaran S, et al. Arterioscler Thromb Vasc Biol. 2023 Nov;43(11):2099-2114. doi: 10.1161/ATVBAHA.123.319399. Epub 2023 Sep 14. Arterioscler Thromb Vasc Biol. 2023. PMID: 37706319 Free PMC article. Review. - Trends in glycemic, blood pressure, and lipid control in adults with diabetes in Switzerland: the CoLaus|PsyCoLaus Study.
Alkandari A, Vaucher J, Marques-Vidal P. Alkandari A, et al. BMJ Open Diabetes Res Care. 2023 May;11(3):e003377. doi: 10.1136/bmjdrc-2023-003377. BMJ Open Diabetes Res Care. 2023. PMID: 37188394 Free PMC article.
Publication types
MeSH terms
Substances
LinkOut - more resources
Full Text Sources
Medical