People with type 1 diabetes who intensively control their blood glucose (blood sugar) early in their disease are likely to live longer than those who do not, according to research funded by the National Institutes of Health. The findings are the latest results of the Diabetes Control and Complications Trial (DCCT) and its follow-up, the Epidemiology of Diabetes Control and Complications (EDIC) study. Results were published online Jan. 6 in the Journal of the American Medical Association.
“The outlook for people with type 1 diabetes continues to improve,” said
Catherine Cowie, Ph.D., of NIH’s National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), the primary funder of the study. “These results show that by tightly controlling their blood glucose, people with type 1 diabetes can live longer.”
Type 1 diabetes typically occurs in younger people and was formerly called juvenile-onset diabetes. In type 1 diabetes, the body does not make insulin, and people with type 1 need to take daily insulin to live.
Beginning in 1983, the DCCT/EDIC study enrolled 1,441 people between ages 13 and 39 with recent-onset type 1 diabetes. In the DCCT, half were assigned at random to intensive blood glucose control designed to keep blood glucose as close to normal as safely possible, and half to the conventional treatment at the time. Both groups were similar in age. The DCCT ended in 1993 when the intensive control group was found to have substantially less eye, nerve and kidney disease. All participants were taught intensive blood glucose control and followed during the ongoing EDIC. Blood glucose control has been similar in both groups since DCCT ended.
Researchers found 107 deaths among DCCT/EDIC participants, who were followed an average of 27 years from enrollment. There were 64 deaths in the group that had initially received standard treatment and 43 deaths in the intensive treatment group, a 33 percent reduction in deaths. The most common causes of death – not all necessarily related to diabetes – were cardiovascular diseases (22 percent), cancer (20 percent), acute diabetes complications – where blood glucose became dangerously high or low (18 percent) – and accidents/suicide (17 percent).
More people in the conventional treatment group than the intervention group died from diabetic kidney disease (six vs. one). The study also found that higher average glucose levels and increased protein in the urine – a marker of diabetic kidney disease –were the major risk factors for death.
Early Blood Sugar Control Lengthens Life In People With Type 1 Diabetes was originally published on blackdoctor.org