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Neuropathy Among the Diabetes Control and Complications Trial Cohort 8 Years After Trial Completion
Open accessAbstract
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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“Subsequent observational data from long-term follow up after termination of randomization periods of both the DCCT and UKPDS cohorts showed a persistence of significant microvascular benefits and also demonstrated an emergence of beneficial effect on CV outcomes attributed to intensive glycemic control.This has been termed as”
From Targets for Glycemic Control (2018) · cites this paper as [15]
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“Follow-up of the DCCT cohorts in the Epidemiology of Diabetes Interventions and Complications (EDIC) study has shown persistence of this effect in previously intensively treated subjects, even though their glycemic control has been equivalent to that of previous standard arm subjects during follow-up (46,47).”
From Standards of Medical Care in Diabetes—2009 (2009) · cites this paper as [47]
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Metadata
- 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
- 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
- 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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