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- Title
Glycemic Control and Cardiovascular Disease in Patients With Type 1 Diabetes.
- Authors
Narayan, K. M. Venkat
- Abstract
Objective. To investigate whether the use of intensive glycemic control versus conventional therapy during the Diabetes Control and Complications Trial (DCCT) affected the long-term incidence of cardiovascular disease (CVD). Design. The DCCT randomly assigned 1,441 patients with type 1 diabetes to intensive or conventional therapy, treating them for a mean of 6.5 years. Ninety-three percent were subsequently followed for CVD in the Epidemiology of Diabetes Interventions and Complications (EDIC) study. Setting. Multicenter study in the United States. End points. CVD was defined as nonfatal myocardial infarction, stroke, death from CVD, confirmed angina, or the need for coronary artery revascularization. Results. At the end of the DCCT, after 6.5 years of treatment, mean hemoglobin Ale (A1C) was 7.4% in the intensive group and 9.1% in the conventional group. After an additional 11 years of follow-up, during which the conventional group received more intensive therapy, A1C levels were 7.9 and 7.8% in the DCCT intensive and conventional groups, respectively. Intensive treatment reduced the risk of any CVD event by 42% (95% CI 9-63) and the risk of nonfatal myocardial infarction, stroke, or death from CVD by 57% (12-79). The change in A1C during 6.5 years of treatment in the DCCT was significantly associated with most of the positive effects of intensive treatment on CVD. Conclusion. Intensive glycemic therapy reduces the risk of CVD in patients with type 1 diabetes.
- Subjects
TREATMENT of diabetes; CARDIOVASCULAR diseases; DIABETES complications; PATIENTS; MYOCARDIAL infarction; PEOPLE with diabetes
- Publication
Clinical Diabetes, 2006, Vol 24, Issue 2, p88
- ISSN
0891-8929
- Publication type
Article
- DOI
10.2337/diaclin.24.2.88