The NIDDK Takes on the Complications of Type 1 Diabetes: The Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications (DCCT/EDIC) Study

Document Type

Journal Article

Publication Date

4-24-2025

Journal

Diabetes care

DOI

10.2337/dc24-2885

Abstract

In the Diabetes Control and Complications Trial (DCCT) (1983-1993), intensive therapy aimed at near-normal glycemia was compared with conventional therapy in 1,441 adolescent and adult participants with type 1 diabetes (T1D) over a mean follow-up of 6.5 years. The primary DCCT results, reported in 1993, demonstrated the benefits of intensive therapy (mean HbA1c ∼7%) compared with conventional therapy (HbA1c ∼9%) in reducing the risk of development and progression of microvascular complications by 35%-76%. HbA1c <7% was adopted worldwide as the therapeutic target for T1D. Subsequently, the Epidemiology of Diabetes Interventions and Complications (EDIC) study (1994-present) was initiated as the observational follow-up of the DCCT cohort. EDIC has shown that the early beneficial effects of intensive versus conventional therapy on complications persisted for ∼10 years after the convergence of HbA1c levels in the two groups during EDIC-a novel concept termed "metabolic memory." During EDIC, prior intensive therapy was also shown to reduce the risk of severe microvascular complications, cardiovascular disease, mortality, and, recently, of age-related outcomes including cognitive impairment, bone loss, and reduced mobility. The DCCT/EDIC cohort is the most extensively studied T1D cohort in history. The participants have been followed and deeply phenotyped for 95% of their diabetes durations and 65% of their lifespans. Throughout its 40+ years, funded by and in close collaboration with the National Institute of Diabetes and Digestive and Kidney Diseases, DCCT/EDIC has generated results that have guided treatment priorities in T1D and led to improved survival and quality of life for millions of people with T1D worldwide.

Department

Biostatistics and Bioinformatics

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