The diabetes control and complications trial/epidemiology of diabetes interventions and complications study at 30 years: overview
Open accessAbstract
OBJECTIVE: The Diabetes Control and Complications Trial (DCCT) was designed to test the glucose hypothesis and determine whether the complications of type 1 diabetes (T1DM) could be prevented or delayed. The Epidemiology of Diabetes Interventions and Complications (EDIC) observational follow-up determined the durability of the DCCT effects on the more-advanced stages of diabetes complications including cardiovascular disease (CVD). RESEARCH DESIGN AND METHODS: The DCCT (1982–1993) was a controlled clinical trial in 1,441 subjects with T1DM comparing intensive therapy (INT), aimed at achieving levels of glycemia as close to the nondiabetic range as safely possible, with conventional therapy (CON), which aimed to maintain safe asymptomatic glucose control. INT utilized three or more daily insulin injections or insulin pump therapy guided by self-monitored glucose. EDIC (1994–present) is an observational study of the DCCT cohort. RESULTS: The DCCT followed >99% of the cohort for a mean of 6.5 years and demonstrated a 35–76% reduction in the early stages of microvascular disease with INT, with a median HbA1c of 7%, compared with CONV, with a median HbA1c of 9%. The major adverse effect of INT was a threefold increased risk of hypoglycemia, which was not associated with a decline in cognitive function or quality of life. EDIC showed a durable effect of initial assigned therapies despite a loss of the glycemic separation (metabolic memory) and demonstrated that the reduction in early-stage complications during the DCCT translated into substantial reductions in severe complications and CVD. CONCLUSIONS: DCCT/EDIC has demonstrated the effectiveness of INT in reducing the long-term complications of T1DM and improving the prospects for a healthy life span.
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The Diabetes Control and Complications Trial and the follow-up Epidemiology of Diabetes Interventions and Complications trial convincingly showed that achieving and maintaining glucose concentrations as close to those seen in people without diabetes as possible leads to a reduction in microvascular and cardiovascular type 1 diabetes complications.
“This trial and the follow-up observational Epidemiology of Diabetes Interventions and Complications trial convincingly showed that achieving and maintaining glucose concentrations as close to those seen in people without diabetes as possible leads to a reduction in microvascular and cardiovascular type 1 diabetes complications.82”
From Type 1 diabetes (2018) · cites this paper as [82]
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Heise, M., Heidemann, C., Baumert, J., Du, Y., Frese, T., Avetisyan, M., & Weise, S. (2022) · Primary Care Diabetes · doi:10.1016/j.pcd.2022.03.016 · Cited by 15 · see citing works
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- Authors
- Nathan, D. M., & for the DCCT/EDIC Research Group
- Affiliations
- George Washington University (US)
- Corresponding author
- Nathan, David M.
- Venue
- Diabetes Care
- Publisher
- American Diabetes Association
- Published
- 2013-12-11
- Volume
- 37
- Issue
- 1
- Pages
- 9-16
- ISSN
- 0149-5992 (ISSN-L)
- 1935-5548
- PMC
- PMC3867999
- OpenAlex
- W2147602249
- Cited by
- 1,832
- References
- 46
- Citations by year
- 2026: 79 · 2025: 122 · 2024: 152 · 2023: 158 · 2022: 218 · 2021: 199 · 2020: 190 · 2019: 149 · 2018: 121 · 2017: 96 · 2016: 76 · 2015: 104 · 2014: 77 · 2013: 76 · 2012: 14
- FWCI
- 87.31
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- cc-by-nc-nd
- Locations
- Diabetes Care (publishedVersion, cc-by-nc-nd)
- Europe PMC (PubMed Central) (publishedVersion, cc-by-nc-nd)
- PubMed Central (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- Funders
- Eli Lilly and Company
- Sanofi
- BD
- Roche Diabetes Care
- National Institutes of Health (UL1TR000041, 5u01dk094157-13, UL1TR001449, UL1TR000457)
- Abbott Diabetes Care
- National Eye Institute
- National Institute of Diabetes and Digestive and Kidney Diseases (U01DK094176, U01 DK094176 and U01 DK094157, U01-DK094157)
- National Institute of Neurological Disorders and Stroke
- National Center for Advancing Translational Sciences
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Education
- Keywords
- type 1 diabetes, intensive insulin therapy, glycemic control, diabetes complications, microangiopathy, cardiovascular disease, hypoglycemia, metabolic memory, HbA1c, long-term outcomes
- MeSH terms
- Adolescent, Adult, Aged, Diabetes Mellitus, Type 1, Dose-Response Relationship, Drug, Female, Glycated Hemoglobin, Humans, Hypoglycemia, Insulin, Insulin Infusion Systems, Male, Middle Aged, Risk Factors, United States, Incidence, Randomized Controlled Trials as Topic, Treatment Outcome, Diabetes Complications, Young Adult
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
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