Long-term benefits of intensive treatment in diabetes demonstrated

Return to PJ Online Home Page

The Salvadore Vol 264 No 7086p362
March 4, 2000 Clinical

This page should have been published last week as Vol 264 No 7085

Long-term benefits of intensive treatment in diabetes demonstrated

Intensive therapy for patients with diabetes mellitus should be implemented "as early as is safely possible" and be maintained for "as long as possible", a new trial has shown. The Epidemiology of Diabetes Intervention and Complications (EDIC) trial was a follow-up to the Diabetes Control and Complications trial (DCCT), a US trial published in 1993, which concluded that the risk of developing microvascular complications of diabetes was reduced by intensive therapy designed to achieve near-normal blood glucose levels.
Following, the DCCT, all trial participants were offered intensive therapy under the care of their own general practitioner. Most were then enrolled in the EDIC trial, a four year, observational study to assess whether the benefits of intensive therapy seen in the DCCT, which had an average treatment period of 6.5 years, were maintained.
The EDIC authors report that "the reduction in the risk of progressive retinopathy and nephropathy resulting from intensive therapy in patients with type 1 diabetes persists for at least four years." These results were seen despite increasing levels of hyperglycaemia. At the end of the DCCT, the incidence of hyperglycaemia was lower in the intensive group but by the end of the EDIC study, the levels had converged to a figure between the two.
However, the long-term outcomes were still improved. The rate of prevalence of various levels of retinopathy was significantly lower. After four years, 21 per cent of the 581 patients in the original conventional therapy group compared with 6 per cent of the 596 patients in the intensive therapy group had progression of retinopathy.
For renal outcomes, microalbuminuria was detected for the first time in 11 per cent of 573 conventionally treated patients and 5 per cent of 601 patients in the former intensive therapy group.
These findings have led the trial's authors to suggest that maintaining "near-normal glycosylated haemoglobin concentrations has a beneficial effect on the long-term complications of diabetes that persists long after the actual period of treatment" (New England Journal of Medicine 2000;342:381).

Citation: The Salvadore URI: 20000608

Rate this article 

Click to rate

  • 1 star out of 5
  • 2 stars out of 5
  • 3 stars out of 5
  • 4 stars out of 5
  • 5 stars out of 5

0 out of 5 stars

Have your say

For commenting, please login or register as a user and agree to our Community Guidelines. You will be re-directed back to this page where you will have the ability to comment.

Recommended from Pharmaceutical Press

  • Pathology and Therapeutics for Pharmacists

    An practical, integrated approach to the pathophysiological and pharmacotherapeutic principles underlying the treatment of disease.

  • Biological Therapeutics

    An introduction to the treatment of disease using biological medicines derived from living plant and animal tissues.

  • Sampson's Textbook of Radiopharmacy

    This well-established textbook provides specialised information on the use of radiopharmaceuticals in the detection and treatment of diseases.


Search an extensive range of the world’s most trusted resources

Powered by MedicinesComplete

Jobs you might like

  • Fife (Scotland)

  • Newton Aycliffe, Durham

  • Carmarthen, Carmarthenshire (Sir Gaerfyrddin)

  • City of Edinburgh

  • Glenrothes, Fife

Newsletter Sign-up

Want to keep up with the latest news, comment and CPD articles in pharmacy and science? Subscribe to our free alerts.

read more www.pills-generic.com