Diabetes Dateline

Follow-up Study Shows That Tight Control Slows the Progression of Kidney Disease

Benefits of strict glucose control in type 1 diabetes persist years after intensive therapy, slowing the progression of diabetic nephropathy, according to a study published in the October 22–29, 2003, issue of the New England Journal of Medicine.

Results from the Epidemiology of Diabetes Interventions and Complications (EDIC) study, a followup of participants in the Diabetes Control and Complications Trial (DCCT), showed that 7 to 8 years after the conclusion of the DCCT, participants who maintained strict control of glucose levels during the DCCT had decreased excretion of albumin (a precursor of end-stage renal disease) and reduced incidence of hypertension compared with participants who had higher average blood glucose levels during the DCCT. These effects occurred even though the difference in mean hemoglobin A1C value between the two former treatment groups differed by only 0.2 percent during the follow-up study period. The mean hemoglobin A1C values in the intensive-treatment group gradually rose after the DCCT study concluded.

Although the mechanism for this protective effect is not yet known, the authors suggest that those with type 1 diabetes begin intensive treatment as early as possible to slow the development of diabetic microvascular disease.

NIH Publication No. 04–4562
May 2004