Landmark Study Proves Benefit of Blood Sugar Control
(American Health, September 1993)
It's been hailed as the most important diabetes breakthrough since insulin: Researchers have confirmed that insulin-dependent diabetics who control their blood sugar levels tightly can stave off the disease's devastating complications. But it's unclear how many diabetics will adhere to the ardous regimen or will achieve optimal sugar levels if they do.
The Diabetes Control and Complications Trial (DCCT) involved 1,441 insulin-dependent (type 1) diabetes patients, aged 13 to 39, at 29 medical centers in North America. Half of them followed the standard regimen of testing the blood with a finger prick once or twice a day and injecting one or two insulin shots; the other half aggressively monitored and controlled their blood with four or more finger pricks a day and giving themselves three or four insulin shots.
Five to 10 years later, researchers found that the tight-controlled patients had fared much better than the standard-treatment group. Cases of clinically significant kidney damage were reduced by half, and incidence of nerve damage, which can lead to limb amputations, was reduced by 60%.
Tight control also delayed the onset of diabetic retinopathy, a potentially blinding eye disorder. These benefits occurred even though blood sugar levels in the tight-controlled group still averaged 40% above those of nondiabetics.
"Insulin is the best treatment we have, but it's far from perfect," says Dr. Allan Drash, a professor of pediatrics who headed the DCCT center at the University of Pittsburgh School of Medicine. "Unless we find additional pharmacological approaches, I don't think we'll ever achieve ideal control."
People on the strict regimen faced a threefold higher risk of having episodes of hypoglycemia, a dangerous drop in blood sugar that can cause unconsciousness or even death. But researchers concluded that the benefits of tight control far outweighed this risk.
While the study applies only to the 1.4 million Americans with insulin-dependent diabetes, the results suggest that the 12 million Americans with non-insulin-dependent (type II) diabetes might also benefit from more intensive efforts to control blood sugar. ###
Copyright © Miriam Tucker. All rights reserved.