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Neuropathy Among the Diabetes Control and Complications Trial Cohort 8 Years After Trial Completion

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Martin, Catherine L., Albers, James, Herman, William H., Cleary, Patricia, Waberski, Barbara, Greene, Douglas A., Stevens, Martin J., Feldman, Eva L.·2006·Diabetes Care

DOI 10.2337/diacare.29.02.06.dc05-1549PMC PMC2622720

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Abstract

OBJECTIVE—To evaluate the impact of prior intensive diabetes therapy on neuropathy among former Diabetes Control and Complications Trial (DCCT) participants. RESEARCH DESIGN AND METHODS—At the conclusion of the DCCT, subjects in the intensive group were encouraged to maintain intensive therapy, and subjects in the conventional group were encouraged to begin intensive therapy. Thereafter, we annually assessed neuropathy as part of the Epidemiology of Diabetes Intervention and Complications (EDIC) study. Neuropathy was defined using the Michigan Neuropathy Screening Instrument (MNSI). We recorded potential adverse consequences of neuropathy. RESULTS—At the first EDIC examination, 1,257 subjects participated in the neuropathy assessment. Consistent with DCCT results, the former intensive group showed a lower prevalence of neuropathy than the conventional group based on positive questionnaire (1.8 vs. 4.7%; P = 0.003) or examination (17.8 vs. 28.0%; P < 0.0001) results. Despite similar levels of glycemic control, symptoms and signs of neuropathy remained less prevalent among the former intensive group compared with the conventional group. At the beginning of the EDIC study, prior intensive therapy reduced the odds of having symptoms and signs of neuropathy using MNSI criteria by 64% (P = 0.0044) and 45% (P < 0.0001), respectively, with similar odds reductions observed for both neuropathic symptoms (51%, P < 0.0001) and neuropathic signs (43%, P < 0.0001) across 8 years of EDIC follow-up. CONCLUSIONS—The benefits of 6.5 years of intensive therapy on neuropathy status extended for at least 8 years beyond the end of the DCCT, similar to the findings described for diabetic retinopathy and nephropathy.

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Authors: Martin, C. L., Albers, J., Herman, W. H., Cleary, P., Waberski, B., Greene, D. A., Stevens, M. J., & Feldman, E. L.
Affiliations: Diabetes Control and Complications Trial (DCCT)/Epidemiology of Diabetes Intervention and Complications (EDIC) Research Group
ORCID: Martin, Catherine L.
Stevens, Martin J.
Feldman, Eva L.
Venue: Diabetes Care
Publisher: American Diabetes Association
Published: 2006-02-01
Volume: 29
Issue: 2
Pages: 340-344
ISSN: 0149-5992 (ISSN-L)
1935-5548
DOI: 10.2337/diacare.29.02.06.dc05-1549
PMC: PMC2622720
OpenAlex: W2010740931
Cited by: 350
References: 15
Citations by year: 2026: 4 · 2025: 2 · 2024: 6 · 2023: 14 · 2022: 7 · 2021: 8 · 2020: 14 · 2019: 11 · 2018: 16 · 2017: 16 · 2016: 17 · 2015: 19 · 2014: 30 · 2013: 26 · 2012: 22
FWCI: 20.92
Type: journal article
Language: en
Open access: bronze
doi.org
Locations: Diabetes Care (publishedVersion)
PubMed (publishedVersion)
PubMed Central (acceptedVersion)
University of Birmingham Research Portal (University of Birmingham) (submittedVersion)
Funders: Eli Lilly and Company
National Institutes of Health (n01dk062204-003)
National Institute of Diabetes and Digestive and Kidney Diseases (N01 DK062204)
National Center for Research Resources
Topics: Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
Health Sciences › Medicine › Physiology (medical) › Pain Mechanisms and Treatments
Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetic Foot Ulcer Assessment and Management
Keywords: diabetic neuropathy, intensive diabetes therapy, Diabetes Control and Complications Trial, Michigan Neuropathy Screening Instrument, glycemic control, long-term follow-up, type 1 diabetes
MeSH terms: Diabetes Mellitus, Type 1, Diabetic Neuropathies, Follow-Up Studies, Health Surveys, Glycated Hemoglobin, Humans, Hypoglycemic Agents, Insulin, Surveys and Questionnaires

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Neuropathy Among the Diabetes Control and Complications Trial Cohort 8 Years After Trial Completion

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