• Online Features  This Article  • Full text  • PDF  • Reply to article  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Citing articles on Web of Science (13)  • Contact me when this article is cited  Related Content  • Similar articles in this journal  Topic Collections  • Nutritional and Metabolic Disorders  • Nutritional and Metabolic Disorders, Other  • Diabetic Retinopathy  • Prognosis/ Outcomes  • Articles for Residents  • Drug Therapy  • Drug Therapy, Other  • Endocrine Diseases  • Diabetes Mellitus  • Alert me on articles by topic  Social Bookmarking   What's this?

10 Years After the Diabetes Control and Complications Trial

Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications Research Group^*

Arch Ophthalmol. 2008;126(12):1707-1715.

Objective  To examine the persistence of the original treatment effects 10 years after the Diabetes Control and Complications Trial (DCCT) in the follow-up Epidemiology of Diabetes Interventions and Complications (EDIC) study. In the DCCT, intensive therapy aimed at near-normal glycemia reduced the risk of microvascular complications of type 1 diabetes mellitus compared with conventional therapy.

Methods  Retinopathy was evaluated by fundus photography in 1211 subjects at EDIC year 10. Further 3-step progression on the Early Treatment Diabetic Retinopathy Study scale from DCCT closeout was the primary outcome.

Results  After 10 years of EDIC follow-up, there was no significant difference in mean glycated hemoglobin levels (8.07% vs 7.98%) between the original treatment groups. Nevertheless, compared with the former conventional treatment group, the former intensive group had significantly lower incidences from DCCT close of further retinopathy progression and proliferative retinopathy or worse (hazard reductions, 53%-56%; P < .001). The risk (hazard) reductions at 10 years of EDIC were attenuated compared with the 70% to 71% over the first 4 years of EDIC (P < .001). The persistent beneficial effects of former intensive therapy were largely explained by the difference in glycated hemoglobin levels during DCCT.

Conclusion  The persistent difference in diabetic retinopathy between former intensive and conventional therapy ("metabolic memory") continues for at least 10 years but may be waning.

Trial Registration  clinicaltrials.gov Identifiers: NCT00360815 and NCT00360893.

*Authors/Group Information: A complete listing of the authors and Diabetes Control and Complications Trial (DCCT)/Epidemiology of Diabetes Interventions and Complications (EDIC) Research Group and their affiliations appears in the Author Information section.

CiteULike    Connotea    Delicious    Digg    Facebook    Reddit    Technorati    Twitter     What's this?

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Epidemiology, risk factors and management of paediatric diabetic retinopathy
Sultan et al.
Br J Ophthalmol 2012;0:bjophthalmol-2011-300169v-bjophthalmol-2011-300169.
ABSTRACT | FULL TEXT  

Beyond AREDS: Is There a Place for Antioxidant Therapy in the Prevention/Treatment of Eye Disease?
Kowluru and Zhong
IOVS 2011;52:8665-8671.
ABSTRACT | FULL TEXT  

Time for a Victory Lap or Time to Raise the Levees: A Perspective on Complication Reduction and New-Onset Diabetes
Wrobel and Reiber
Diabetes Care 2011;34:2130-2132.
FULL TEXT  

Comparability of Digital Photography with the ETDRS Film Protocol for Evaluation of Diabetic Retinopathy Severity
Li et al.
IOVS 2011;52:4717-4725.
ABSTRACT | FULL TEXT  

Comparison of Digital and Film Grading of Diabetic Retinopathy Severity in the Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications Study
Hubbard et al.
Arch Ophthalmol 2011;129:718-726.
ABSTRACT | FULL TEXT  

The Question Is, My Dear Watson, Why Did the Dog Not Bark?: The Joslin 50-Year Medalist Study
Vinik
Diabetes Care 2011;34:1060-1063.
FULL TEXT  

Review of therapeutic advances in diabetic retinopathy
Chen and Shah
Therapeutic Advances in Endocrinology and Metabolism 2011;2:39-53.
ABSTRACT  

The Burgeoning Public Health Impact of Diabetes: The Role of the Ophthalmologist
Beck
Arch Ophthalmol 2011;129:225-229.
ABSTRACT | FULL TEXT  

Status of Hemoglobin A1c Measurement and Goals for Improvement: From Chaos to Order for Improving Diabetes Care
Little et al.
Clin. Chem. 2011;57:205-214.
ABSTRACT | FULL TEXT  

Using a Cell Phone-Based Glucose Monitoring System for Adolescent Diabetes Management
Carroll et al.
The Diabetes Educator 2011;37:59-66.
ABSTRACT | FULL TEXT  

Effect of Prior Intensive Insulin Treatment During the Diabetes Control and Complications Trial (DCCT) on Peripheral Neuropathy in Type 1 Diabetes During the Epidemiology of Diabetes Interventions and Complications (EDIC) Study
Albers et al.
Diabetes Care 2010;33:1090-1096.
ABSTRACT | FULL TEXT  

Effect of Prior Intensive Therapy in Type 1 Diabetes on 10-Year Progression of Retinopathy in the DCCT/EDIC: Comparison of Adults and Adolescents
White et al.
Diabetes 2010;59:1244-1253.
ABSTRACT | FULL TEXT  

Glyceraldehyde-3-Phosphate Dehydrogenase in Retinal Microvasculature: Implications for the Development and Progression of Diabetic Retinopathy
Madsen-Bouterse et al.
IOVS 2010;51:1765-1772.
ABSTRACT | FULL TEXT  

Genetic Polymorphisms in Genes Encoding Antioxidant Enzymes Are Associated With Diabetic Retinopathy in Type 1 Diabetes
Hovnik et al.
Diabetes Care 2009;32:2258-2262.
ABSTRACT | FULL TEXT  

Review: Metabolic memory in type 1 diabetes
Wright
British Journal of Diabetes & Vascular Disease 2009;9:254-257.
ABSTRACT  

Effect of Glucose Variability on the Long-Term Risk of Microvascular Complications in Type 1 Diabetes
Kilpatrick et al.
Diabetes Care 2009;32:1901-1903.
ABSTRACT | FULL TEXT  

Metabolic Memory in the Autonomic Neuropathy of Diabetes: Implications for Pathogenesis and Patient Care
Chaturvedi
Circulation 2009;119:2865-2867.
FULL TEXT  

Progress in Diabetes Research--What's Next
Nathan
JAMA 2009;301:1599-1601.
FULL TEXT  

Metabolic Memory in Diabetes Is True Long-term Memory
Frank
Arch Ophthalmol 2009;127:330-331.
FULL TEXT