Mortality in type 1 diabetes in the DCCT/EDIC versus the general population
Open accessAbstract
Objective Historically, mortality in type 1 diabetes has exceeded that in the general population. We compared mortality in the Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications (DCCT/EDIC) study cohort to that of the current general U.S. Research design and methods The DCCT (1983-1993) compared intensive versus conventional therapy, with HbA1c levels of ∼7 vs. 9%, respectively, over an average of 6.5 years of treatment. EDIC is the observational follow-up study of the DCCT (1994 to the present). Vital status was ascertained for 97.5% of the original DCCT cohort (n = 1,441) after a mean of 27 years follow-up. Expected mortality during DCCT/EDIC was estimated using the current age-, sex-, and race-specific risks in the general U.S. population, and the observed versus expected mortality compared using standardized mortality ratios (SMRs) and Poisson regression models. Results Mortality in the DCCT intensive therapy group was nonsignificantly lower than that in the general U.S. population (SMR = 0.88 [95% CI 0.67, 1.16]), whereas mortality in the DCCT conventional therapy group was significantly greater than that in the general population (SMR = 1.31 [95% CI 1.05, 1.65]). The SMR increased with increasing mean HbA1c, and above an HbA1c of 9%, the rate of increase in SMR among females was greater than that among males. Conclusions Overall mortality in the combined DCCT/EDIC cohort was similar to that of the general population but was…
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In the DCCT, lower A1C with intensive management (7%) led to ≥50% reductions in microvascular complications over 6 years of treatment.
“In this landmark trial, lower A1C with intensive management (7%) led to $50% reductions in microvascular complications over 6 years of treatment.”
From 9. Pharmacologic Approaches to Glycemic Treatment: Standards of Care in Diabetes—2025 (2025) · cites this paper as [1]
In the DCCT, intensive therapy was associated with a higher rate of severe hypoglycemia than conventional treatment (62 compared with 19 episodes per 100 person-years of therapy).
“However, intensive therapy was associated with a higher rate of severe hypoglycemia than conventional treatment (62 compared with 19 episodes per 100 person-years of therapy) (1).”
From 9. Pharmacologic Approaches to Glycemic Treatment: Standards of Care in Diabetes—2025 (2025) · cites this paper as [1]
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- Authors
- The Diabetes Control and Complications Trial (DCCT)/Epidemiology of Diabetes Interventions and Complications (EDIC) Study Research Group
- Corresponding author
- The Diabetes Control and Complications Trial (DCCT)/Epidemiology of Diabetes Interventions and Complications (EDIC) Study Research Group
- Venue
- Diabetes Care
- Publisher
- American Diabetes Association
- Published
- 2016-07-12
- Volume
- 39
- Issue
- 8
- Pages
- 1378-1383
- ISSN
- 0149-5992 (ISSN-L)
- 1935-5548
- PMC
- PMC4955932
- OpenAlex
- W2567623101
- Cited by
- 194
- References
- 2
- Citations by year
- 2026: 9 · 2025: 13 · 2024: 20 · 2023: 15 · 2022: 22 · 2021: 26 · 2020: 23 · 2019: 26 · 2018: 17 · 2017: 19 · 2016: 4
- FWCI
- 22.09
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Diabetes Care (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Division of Diabetes Endocrinology and Metabolic Diseases of the National Institute of Diabetes and Digestive and Kidney Diseases (U01 DK094176, U01 DK094157)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Education
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Keywords
- type 1 diabetes, mortality, intensive insulin therapy, conventional therapy, HbA1c, glycemic control, standardized mortality ratio, sex differences, vital status
- MeSH terms
- Adolescent, Adult, Blood Glucose, Diabetes Mellitus, Type 1, Female, Follow-Up Studies, Glycated Hemoglobin, Humans, Insulin, Male, Risk Factors, United States, Cohort Studies, Randomized Controlled Trials as Topic, Young Adult
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