Celebrating 30 Years of Research Accomplishments of the Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications Study
- 1Division of Diabetes, Endocrinology, and Metabolic Diseases, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, Maryland
- 2Office of Scientific Program and Policy Analysis, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, Maryland
- 3National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, Maryland
- Corresponding author: Judith E. Fradkin, .
The landmark Diabetes Control and Complications Trial (DCCT) and its follow-up study, the Epidemiology of Diabetes Interventions and Complications (EDIC), have changed the way that type 1 diabetes is treated, and have led to improvements in the health and quality of life of people with the disease. In this Perspective, we look back at the 30 years since the start of DCCT to celebrate the scientific achievements of the DCCT/EDIC study group and patient volunteers—achievements that have had far-reaching benefits for type 1 diabetes and beyond. The insights that continue to emerge from DCCT/EDIC underscore the importance of supporting long-term research on chronic diseases such as type 1 diabetes. We also describe factors that contributed to the success of DCCT/EDIC, its public health implications, and how results continue to inform current-day research directions supported by the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) of the National Institutes of Health (NIH). A complementary Perspective from the DCCT/EDIC investigators summarizes the methods, and results, and clinical implications of these seminal studies (1).
A UNIQUE TIME TO ANSWER AN IMPORTANT QUESTION ABOUT TYPE 1 DIABETES MANAGEMENT
In the late 1970s to the early 1980s, there was considerable debate about whether the potential benefits of intensive glycemic control in reducing the development of diabetes complications outweighed the risks of hypoglycemia (2–4). The studies done before the DCCT were small and short in duration and had enrolled subjects with preexisting retinopathy, thus failing to resolve the controversy about the risks and benefits of intensive treatment or to address primary prevention. Moreover, some studies in individuals with established eye disease showed an early worsening of retinopathy with intensive blood glucose control (5–7). Delineation of the natural history of the preproliferative phases of diabetic retinopathy in conventionally treated type 1 diabetes and validation of retinal photography as an outcome measure provided the …