About Diabetes Complications
The Diabetes Control and Complications Trial (DCCT), a landmark ten-year study of the impact of good blood sugar control on complications associated with type 1 diabetes, found that for every 1 percentage point a patient reduces their A1C (i.e., three-month blood glucose average), they lower their risk of microvascular complications 37%. The study also found that keeping blood sugar levels as close to normal as possible slowed the progression of diabetes-related eye, kidney, and nerve diseases.
A ten-year study of over 5,000 patients with newly diagnosed type 2 diabetes – The United Kingdom Prospective Diabetes Study (UKPDS) – found that the diabetes-related complications of retinopathy, nephropathy, and neuropathy were reduced significantly in study subjects with type 2 diabetes who practiced intensive blood glucose control (i.e., a median A1C of 7%).In addition, for every percentage point reduction in A1C, study participants achieved a 35% reduction in the risk of complications. The UKPDS also found that aggressive control of high blood pressure significantly reduced cardiovascular complications and diabetic retinopathy in people with type 2 diabetes.
1 - National Diabetes Information Clearinghouse. Diabetes Overview. (Accessed 2/19/08).
2 - Centers for Disease Control. Chronic Disease Prevention. (Accessed 2/19/08).
3 - Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications (DCCT/EDIC) Research Group, Nathan DM, Zinman B, Cleary PA, Backlund JY, Genuth S, Miller R, Orchard TJ. Modern-day clinical course of type 1 diabetes mellitus after 30 years' duration: the diabetes control and complications trial/epidemiology of diabetes interventions and complications and Pittsburgh epidemiology of diabetes complications experience (1983-2005). Arch Intern Med 2009 Jul 27;169(14):1307-16.
4 - White NH, Sun W, Cleary PA, Danis RP, Davis MD, Hainsworth DP, Hubbard LD, Lachin JM, Nathan DM. Prolonged effect of intensive therapy on the risk of retinopathy complications in patients with type 1 diabetes mellitus: 10 years after the Diabetes Control and Complications Trial. Arch Ophthalmol. 2008 Dec;126(12):1707-15.
5 - Holman RR, Paul SK, Bethel MA, Matthews DR, Neil HA. 10-year follow-up of intensive glucose control in type 2 diabetes. N Engl J Med. 2008 Oct 9;359(15):1577-89. Epub 2008 Sep 10.
Reviewed by Francine Kaufman, MD. 4/08
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My diabetes is changing. Until a few years ago, my morning readings were reasonable and within the desired range of under 100 mg/dl. About two years ago, they started slipping upwards into the less-desirable but apparently not-worrisome range of 100-110 mg/dl. Now, this was what was recorded by my Abbott Freestyle Lite meter, which is known to record at the lower end of the home-glucometer variability range, but with my A1c firmly in the high 5s and low 6s, the meter's tendency to...