The Effect of Intensive Treatment of Diabetes on the Development and Progression of Long‐Term Complications in Insulin‐Dependent Diabetes Mellitus

@article{Nathan1993TheEO,
  title={The Effect of Intensive Treatment of Diabetes on the Development and Progression of Long‐Term Complications in Insulin‐Dependent Diabetes Mellitus},
  author={David M. Nathan and Saul M. Genuth and John M. Lachin and Patricia A. Cleary and O. Crofford and M. Davis and Lawrence I Rand and Carolyn Siebert},
  journal={Survey of Anesthesiology},
  year={1993},
  volume={38},
  pages={173}
}
BACKGROUND Long-term microvascular and neurologic complications cause major morbidity and mortality in patients with insulin-dependent diabetes mellitus (IDDM. [...] Key MethodMETHODS A total of 1441 patients with IDDM--726 with no retinopathy at base line (the primary-prevention cohort) and 715 with mild retinopathy (the secondary-intervention cohort) were randomly assigned to intensive therapy administered either with an external insulin pump or by three or more daily insulin injections and guided by…Expand
Effect of intensive diabetes treatment on the development and progression of long-term complications in adolescents with insulin-dependent diabetes mellitus: Diabetes Control and Complications Trial. Diabetes Control and Complications Trial Research Group.
TLDR
It is concluded that intensive therapy effectively delays the onset and slows the progression of diabetic retinopathy and nephropathy when initiated in adolescent subjects; the benefits outweigh the increased risk of hypoglycemia that accompanies such treatment. Expand
Intensive insulin therapy in insulin-dependent diabetes mellitus, the results of the diabetes control and complications trial.
  • F. Duron
  • Medicine
  • Biomedicine & pharmacotherapy = Biomedecine & pharmacotherapie
  • 1995
TLDR
In insulin-dependent diabetes mellitus, intensive insulin-therapy, as compared with conventional therapy, significantly reduces the risk of developing microvascular and neuropathic complications, and the results of the DCCT raises some questions about indications, the risk/benefit ratio and the cost/ benefit ratio of intensive treatment. Expand
Association between 7 years of intensive treatment of type 1 diabetes and long-term mortality.
TLDR
After a mean of 27 years' follow-up of patients with type 1 diabetes, 6.5 years of initial intensive diabetes therapy was associated with a modestly lower all-cause mortality rate when compared with conventional therapy. Expand
Effect of intensive insulin therapy on progression of overt nephropathy in patients with type 1 diabetes mellitus.
  • T. Aoki, E. Grecu, +5 authors R. Meisenheimer
  • Medicine
  • Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists
  • 1999
TLDR
The addition of CIIIT to intensive subcutaneous insulin therapy in patients with type 1 diabetes mellitus seems to arrest or appreciably reduce the progression of overt diabetic nephropathy, as well as substantially improve their glycemic control. Expand
Intensive insulin therapy prevents the progression of diabetic microvascular complications in Japanese patients with non-insulin-dependent diabetes mellitus: a randomized prospective 6-year study.
TLDR
In conclusion, intensive glycemic control by multiple insulin injection therapy can delay the onset and the progression of diabetic retinopathy, nephropathy and neuropathy in Japanese patients with NIDDM. Expand
Intensive diabetes treatment and cardiovascular disease in patients with type 1 diabetes.
TLDR
Intensive diabetes therapy has long-term beneficial effects on the risk of cardiovascular disease in patients with type 1 diabetes, and changes between treatment groups remained significant after adjusting for these factors. Expand
Effect of intensive diabetes treatment on albuminuria in type 1 diabetes: long-term follow-up of the Diabetes Control and Complications Trial and Epidemiology of Diabetes Interventions and Complications study.
TLDR
In individuals with type 1 diabetes, intensive diabetes treatment yields durable renal benefits that persist for at least 18 years after its application, which should result in fewer patients requiring renal replacement therapy. Expand
Long-term effect of diabetes and its treatment on cognitive function.
TLDR
No evidence of substantial long-term declines in cognitive function was found in a large group of patients with type 1 diabetes who were carefully followed for an average of 18 years, despite relatively high rates of recurrent severe hypoglycemia. Expand
Insulin therapy, hyperglycemia, and hypertension in type 1 diabetes mellitus.
TLDR
Hyperglycemia is a risk factor for incident hypertension in type 1 diabetes, and intensive insulin therapy reduces the long-term risk of developing hypertension. Expand
Association of Glycemic Variability in Type 1 Diabetes With Progression of Microvascular Outcomes in the Diabetes Control and Complications Trial
TLDR
Overall, within-day glycemic variability, as determined from quarterly glucose profiles, does not play an apparent role in the development of microvascular complications beyond the influence of the mean glucose. Expand
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References

SHOWING 1-10 OF 34 REFERENCES
The effect of long-term intensified insulin treatment on the development of microvascular complications of diabetes mellitus.
TLDR
Long-term intensified insulin treatment, as compared with standard treatment, retards the development of microvascular complications in patients with insulin-dependent diabetes mellitus. Expand
The Diabetes Control and Complications Trial (DCCT).
TLDR
In both primary prevention and secondary intervention arms of the trial, intensified control reduced retinopathy risk by half or more, and also reduced nephropathy and neuropathy risks--however, risk of severe hypoglycaemic episodes was increased about three-fold. Expand
Retinopathy in Older Type II Diabetics Association With Glucose Control
TLDR
An etiologie role for metabolic control in the development of retinopathy in the elderly type II population is supported, and both the duration of diabetes and HbA1c remained significant independent determinants of Retinopathy even after taking age and blood pressure into account. Expand
Epidemiology of severe hypoglycemia in the diabetes control and complications trial. The DCCT Research Group.
  • Medicine
  • The American journal of medicine
  • 1991
TLDR
In the DCCT, intensive treatment of IDDM increased the frequency of severe hypoglycemia relative to conventional therapy, and the importance of determining the benefit-risk ratio of intensive and standard therapy of ID DM is underscored. Expand
The response of diabetic retinopathy to 41 months of multiple insulin injections, insulin pumps, and conventional insulin therapy.
TLDR
Transient progression of retinopathy may be related to fluctuations in blood glucose levels, although a favorable effect of long-term improved metabolic control was not documented. Expand
Factors in Development of Diabetic Neuropathy: Baseline Analysis of Neuropathy in Feasibility Phase of Diabetes Control and Complications Trial (DCCT)
  • Medicine
  • Diabetes
  • 1988
TLDR
The somatic and autonomic test results confirm the relationship between age, diabetes duration, and male gender and diabetic neuropathy, and support an effect of age and gender on the development of diabetic complications. Expand
EFFECT OF TWO YEARS OF STRICT METABOLIC CONTROL ON PROGRESSION OF INCIPIENT NEPHROPATHY IN INSULIN-DEPENDENT DIABETES
36 patients with insulin-dependent diabetes mellitus who had 'Albustix'-negative urine but raised urinary albumin excretion (30 to 300 mg/24 h) were randomly assigned to either remaining onExpand
Rapid tightening of blood glucose control leads to transient deterioration of retinopathy in insulin dependent diabetes mellitus: the Oslo study.
TLDR
A large and rapid fall in blood glucose concentration may promote transient deterioration of diabetic retinopathy, and patients who developed cotton wool spots are characterised by a larger decrement in glycosylated haemoglobin and blood glucose values. Expand
Blood glucose control and the evolution of diabetic retinopathy and albuminuria. A preliminary multicenter trial.
TLDR
It is concluded that maintenance of differing levels of blood glucose is feasible in a multicenter trial and that a nearly normal blood glucose level for eight months does not retard progression of, and may initially worsen, established retinopathy. Expand
EFFECT OF 1 YEAR OF NEAR-NORMAL BLOOD GLUCOSE LEVELS ON RETINOPATHY IN INSULIN-DEPENDENT DIABETICS
TLDR
Retinal function improved significantly with CSII treatment and deteriorated significantly with UCT, and changes in retinal function were most pronounced in patients with the best and the poorest regulated glycaemic control. Expand
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