Effect of intensive therapy on the development and progression of diabetic nephropathy in the Diabetes Control and Complications Trial
Open accessAbstract
The Diabetes Control and Complications Trial (DCCT) has demonstrated that intensive diabetes treatment delays the onset and slows the progression of retinopathy, nephropathy, and neuropathy in patients with IDDM. A detailed description of the effects of this treatment on diabetic nephropathy is presented here. In the primary prevention cohort, intensive treatment reduced the mean adjusted risk of the cumulative incidence of microalbuminuria (> or = 28 micrograms/min) by 34% (95% CI 2, 56%; P = 0.04). Furthermore, intensive treatment decreased the albumin excretion rate (AER) by 15% after the first year of therapy (6.5 vs. 7.7 micrograms/min, P or = 28 micrograms/min) by 43% (95% CI 21, 58%; P or = 70 micrograms/min) by 56% (95% CI 26, 74%; P = 0.002); and the risk of clinical albuminuria (> or = 208 micrograms/min) by 56% (95% CI 18, 76%; P or = 28 micrograms/min but or = 208 micrograms/min coupled with a CCr 140/90 mm Hg) differed significantly between treatment groups in the primary, secondary or combined cohorts.(ABSTRACT TRUNCATED AT 400 WORDS)
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In clinical trials, targeting lower HbA1c levels has reduced the rates of chronic diabetes complications in patients with T1D or T2D.
“Moreover, in clinical trials, targeting lower HbA1c levels has reduced the rates of chronic diabetes complications in patients with T1D 190,232 -238 or T2D. 239 -246”
From KDIGO 2022 Clinical Practice Guideline for Diabetes Management in Chronic Kidney Disease (2022) · cites this paper as [237]
Poor control, defined as a hemoglobin A1c level >9.0%, contributes to complications, including nephropathy, retinopathy, and neuropathy.
“Poor control, defined as a hemoglobin A1c (HbA1c) level >9.0%, contributes to complications, including nephropathy [1-6], retinopathy [4,7], and neuropathy [4,8].”
From An Assessment of How Clinicians and Staff Members Use a Diabetes Artificial Intelligence Prediction Tool: Mixed Methods Study (2023) · cites this paper as [5]
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- Authors
- The Diabetes Control and Complications (DCCT) Research Group
- Venue
- Kidney International
- Publisher
- Elsevier BV
- Published
- 1995-06
- Volume
- 47
- Issue
- 6
- Pages
- 1703-1720
- ISSN
- 0085-2538 (ISSN-L)
- OpenAlex
- W4212827053
- Cited by
- 694
- References
- 0
- Citations by year
- 2026: 4 · 2025: 7 · 2024: 15 · 2023: 17 · 2022: 22 · 2021: 15 · 2020: 18 · 2019: 11 · 2018: 20 · 2017: 28 · 2016: 18 · 2015: 31 · 2014: 26 · 2013: 23 · 2012: 23
- FWCI
- 15.42
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Kidney International (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institute of Diabetes and Digestive and Kidney Diseases
- Topics
- Health Sciences › Medicine › Nephrology › Chronic Kidney Disease and Diabetes
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Health Sciences › Medicine › Ophthalmology › Retinal Diseases and Treatments
- Keywords
- diabetic nephropathy, intensive diabetes treatment, urinary albumin excretion rate, microalbuminuria, type 1 diabetes, disease progression, Diabetes Control and Complications Trial, glycemic control, diabetes complications prevention
- MeSH terms
- Adult, Albuminuria, Blood Pressure, Diabetes Mellitus, Diabetic Nephropathies, Female, Follow-Up Studies, Humans, Iothalamic Acid, Kidney, Male, Patient Compliance, Cohort Studies, Disease Progression, Diabetes Complications
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