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I read a study recently outlining the benefits of tight glucose control as a way of reducing the risk of complications from diabetes after an especially long period: 30 years.

Although there are some frustrating limits on the way that data was collected (due to limitations on what has been measured), the rough conclusion was that tight blood glucose control substantially reduces the risk of retinopathy (an eye problem), nephropathy (kidney failure) and cardiovascular disease for people who have had diabetes over the long term. Some of the horror statistics that used to be bandied around (say "diabetics have a 50% chance of dying within 10 years") are simply no longer true for a well controlled group of people with Type One diabetes.

I've now had diabetes for 33 years, so it's a relevant kind of finding.

But: the point I want to make here is that this data has been collected from 1,441 people who joined a study called the landmark Diabetes Control and Complications Trial between 1983 and 1989.

Insulin first became available to treat diabetes in 1921. By the 1940s it was clear that people with diabetes developed complications. When I got diabetes in 1976, it was assumed that good control reduced the risk of complications: but there wasn't much in the way of large scale studies to prove this.

The 1,441 people in who agreed to join the DCCT were the first large group to be studied over time. By 1993 when the results of the study were published, it was clear that tight control made a big difference.

Since then, an overwhelming majority of those people (currently a surprisingly high 1,297 of them) are still involved in a follow up study called EDIC. They are continuing to be measured and examined to this day.

It would, of course, have been nice if a study of this size could have been started (say) back in the 1950s. The DCCT/EDIC people have had diabetes for 2-12 years less than me. What's important is that the medical profession is continuing to reach valuable conclusions based by the overwhelmingly large number of participants who are continuing to make themselves available for study. And they'll forever be the only large group who started being studied as far back as 1983.

And for that, I thank them.

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Anthony Holmes August 5th, 2009 11:52:15 PM

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