WHAT IS DCCT?

All DCCT participants were monitored for diabetic retinopathy, an eye, disease that affects the retina. Study results showed that intensive therapy reduced the risk for developing retinopathy by 76 percent. In participants with some eye damage at the beginning of the study, intensive management slowed the progression of the disease by 54 percent. The retina is the light-sensing tissue at the back of the eye. According to the National Eye Institute, one of the National Institutes of Health, as many as 24,000 persons with diabetes lose their sight each year. In the United States, diabetic retinopathy is the leading cause of blindness in adults under age 65.

Participants in the DCCT were tested to assess the development of diabetic kidney disease (nephropathy). Findings showed that intensive treatment prevented the development and slowed the progression of diabetic kidney disease by 50 percent. Diabetic kidney disease is the most common cause of kidney failure in the United States and the greatest threat to life in adults with IDDM. After having diabetes for 15 years, one-third of people with IDDM develop kidney disease. Diabetes damages the small blood vessels in the kidneys, impair- ing their ability to filter impurities from blood for excretion in the urine. Persons with kidney damage must have a kidney transplant or rely on dialysis to cleanse their blood.

Participants in the DCCT were examined to detect the development of nerve damage (diabetic neuropathy). Study results showed the risk of nerve damage was reduced by 60 percent in persons on intensive treatment. Diabetic nerve disease can cause pain and loss of feeling in the feet, legs, and fingertips. It can also affect the parts of the nervous system that control blood pressure, heart rate, digestion, and sexual function. Neuropathy is a major contributing factor in foot and leg amputations among people with diabetes.

DCCT & Cardiovascular Disease

DCCT participants were not expected to have many heart-related problems because their average age was only 27 when the study began. Nevertheless, they underwent cardiograms, blood pressure tests, and laboratory tests of blood fat levels to look for signs of cardiovascular disease. The study proved that volunteers on intensive treatment had significantly lower risks of developing high blood cholesterol, a cause of heart disease. The risk was 35 percent lower in these volunteers, suggesting that intensive treatment can help prevent heart disease.

What are the risks of Intensive Treatment?

In the DCCT, the most significant side effect of intensive treatment was an increase in the risk for low blood sugar episodes severe enough to require assistance from another person. This is called severe hypoglycemia. Because of this risk, DCCT researchers do not recommend intensive therapy for children under age 13, people with heart disease or advanced complications, older adults, and people with a history of frequent severe hypoglycemia. Persons in the intensive management group also gained a modest amount of weight, suggesting that intensive treatment may not be appropriate for people with diabetes who are overweight. DCCT researchers estimate that intensive management doubles the cost of managing diabetes because of increased visits to health care professionals and the need for more frequent blood testing at home. However, this cost is offset by the reduction in medical expenses related to long- term complications and by the improved quality of life of people with diabetes.

You can’t buy back your Vision

On numerous occasions annually, we are faced with diabetic patients who would pay anything to regain their vision. They often look for a quick fix and think eyeglasses are the answer. Unfortunately, they have neglected their eyes and their general medical health. It is important to look at these DCCT guidelines and to make some critical decisions about your life. We hope we inspire you to make the lifestyle changes that every diabetic needs so that you can maintain a healthy quality of life. We also want you to partner with all of the doctors on your health care team to take the best possible care of your health. As for your eyes, do not avoid regular eye care. It is a troubling statistic that less than all adults with diabetes have ever had their eyes examined!

** information on DCCT reprinted with permission from the National Institute of Health.