Analyzing the 10-Year Diabetes Control and Complications Trial

Not many people have heard of DCCT. The initials stand for Diabetes Control and Complications Trial, a longterm study of 1,441 Type 1 diabetic children and adults undertaken for 10 years, from 1983 to 1993. Participants had to have been diagnosed for at least a year, but not longer than 15 years, as of the beginning of the study, and could not have more than minimal evidence of diabetes-induced eye damage. Researchers basically wanted to see if complications of diabetes were preventable, and if they were, what it took to avoid them. After all, nobody wants to end up blind or on dialysis because the diabetes destroyed one's body.

The study subjects had to do a number of things to achieve tight control. They had to test their blood sugar levels four times a day. They had to follow a strict meal plan and make a monthly visit to a specially-trained health care team consisting of doctors, diabetes nurse managers, behavioral therapists, and dietitian. Patients used either four insulin injections a day or an insulin pump, and they had to adjust their insulin according to a specified protocol depending on their meal schedule, food intake (even if they deviated from their meal plan), and exercise level.

At the end of the DCCT study, researchers found that any sustained lowering of blood sugar levels helped slow complications, even if patients had a history of poor blood sugar control. The study found that intensive treatment - called tight control becasuse it is designed to keep the patient's blood sugar as close to perfectly normal as possible at all times - either prevented complications entirely or slowed their progression.