In 1983, a trial began that would
forever alter the standard of management of type 1 diabetes (T1D) and serve as
a stepping stone to future research advances—and as we mark the 30th
anniversary of the trial’s inception, we are still learning from the study.
The Diabetes Control and
Complications Trial (DCCT),
a 10-year multicenter clinical trial, studied 1,441 people with T1D for an
average of 6.5 years each, to examine whether intensive versus conventional
methods of blood-glucose control could affect one’s development of dangerous diabetes
complications. In 1993, staggering results from the trial proved that intensive
therapy—where participants kept their HbA1c levels as close to normal as
possible through frequent monitoring and insulin injections—reduces the risk of
complications such as diabetic kidney, eye, and nerve disease by 35-76 percent,
compared with what was then considered conventional treatment of one or two
insulin injections daily and one urine or blood glucose test per day.
The DCCT is credited for spurring
a change in the way diabetes is managed. But its effects did not end there.
Most of the participants of the DCCT volunteered for the follow-up study
beginning in 1994, called the Epidemiology of Diabetes Interventions and
study. This subsequent research has continued to uncover insights that could
impact people with T1D today.
In 2002-2003, EDIC researchers
determined that the period of intensive glucose control during the DCCT
continued to reduce the risk of microvascular complications 7-8 years later,
despite comparable glucose control between the two groups of participants after
the initial study. Coined “metabolic memory,” this phenomenon suggests that
implementing intensive glucose control as early as possible could help reduce
the risk of complications down the line.
In 2005, EDIC researchers reported
another interesting statistic: DCCT participants who had undergone intensive
treatment during the study had fewer than half the number of cardiovascular
complications compared with those treated conventionally, throughout an average
of 17 years since their enrollment in the DCCT. For the first time, research
showed that intensive glucose control could have long-term benefits for
reducing heart attacks, strokes, and cardiovascular-related death in people
New insights into hypoglycemia and
the genetics of diabetes complications are also forming from the base of data
that the DCCT study provided 30 years ago. These studies and future ones
highlight the importance of a strong investment in long-term research—an
investment that has been made possible through funding from organizations like
JDRF, and with governmental support through the Special Diabetes Program (SDP),
which makes up roughly one-third of U.S. government support for T1D research.
As advocates of T1D research, we can
help protect and increase critical funding through JDRF and the SDP, so that
long-term studies have the resources needed to continue revealing information
that could improve and save lives. In addition to advocacy, people with T1D and
their families can help research advance by participating in clinical trials.
For more information, visit the JDRF Clinical Trials Connection website: https://trials.jdrf.org/patient/.