Study shows results of tight glucose control

Here's what we know about controlling blood glucose (blood sugar) in people with diabetes: It's not easy, but it can be done. It requires vigilance and resolve. And it can save your life.

A recent study by the National Institutes of Health (NIH) has answered one of the most important questions about diabetes: Can glucose control lower the risk of heart attacks and strokes? The answer is yes - intensive glucose control can reduce the risk by more than half. From 1983 to 1989, the NIH-sponsored Diabetes Control and Complications Trial (DCCT) randomly assigned a large number of people with diabetes to an intensive or conventional treatment group. Those in the intensive group were held to a stricter level of glucose control and were required to self-monitor their own glucose levels throughout the day. The DCCT ended in 1993 after conclusively demonstrating that intensive control better protected against damage to the eyes (retinopathy), kidneys (nephropathy), and nerves (neuropathy).

In 1994, the vast majority of DCCT participants were enrolled in the Epidemiology of Diabetes Interventions and Complications (EDIC) study. This follow-up study simply tracked participants' health; no interventions were provided. Diabetes care was obtained from participants' own physicians.

In the most recent results released late last year in the New England Journal of Medicine, EDIC investigators found that patients who underwent intensive diabetes management in the DCCT study now show 42% fewer cases of total cardiovascular disease and 57% fewer heart attacks, strokes, or cardiovascular deaths.

Amazingly, more than a decade after they left the DCCT and returned to the care of their own doctors, participants are still benefiting from the relatively brief period of intense blood glucose control they had during the study, and they continue to have significantly lower risks for cardiovascular disease, as well as retinopathy, nephropathy, and neuropathy. This is dramatic confirmation of the role of glucose control in reducing the rate of cardiovascular disease in people with diabetes.

The National Diabetes Education Program was launched in 1997 to spread the word about the benefits of glucose control shown by the DCCT. Now, almost ten years later, we know that glucose control can reduce the risk of heart attacks and strokes - the #1 killer of people with diabetes - by more than half. And so we rededicate our outreach to people with diabetes, offering tools and resources to help them control their blood glucose.

NDEP's Control Your Diabetes. For Life. materials are available in more than 20 adaptations: in brochures for lower-literacy audiences as well as for more advanced readers; in bilingual April 2006

materials for Hispanics and Latinos; in culturally-tailored materials for African Americans, American Indians, and Alaska Natives; and in 15 Asian and Pacific Islander languages. These materials teach people with diabetes how to know their ABCs - what their A1C, Blood pressure, and Cholesterol numbers are, what they should be, and how to work with their health care team to reach those goals. Our materials also offer suggestions for sticking to a healthy eating plan, ways to stay active with regular physical activity, and other tips for feeling better and staying healthy. All NDEP materials are grounded in science, backed by the federal government, and copyright free.

We know that achieving glucose control isn't easy. The latest data from the Centers for Disease Control and Prevention (CDC) suggest that fewer than 45% of Americans with diabetes are achieving the level of glucose control experienced by participants in the intensive treatment group of DCCT/EDIC. But people with diabetes and their health care providers must continue to work together to reach and maintain such control. It can save your sight. It can save your kidneys. It can save your limbs. And it can save your life.