Have treatments for type 1 diabetes improved?

In this video Griffin Rodgers, MD, director of diabetes, digestive and kidney disease at the National Institutes of Health, discusses the long-term study that has increased life expectancy and reduced eye disease risk for those with type 1 diabetes.

Transcript

00:00

Treatments for type 1 diabetes-- let me start with that-- have actually improved quite greatly.

00:07

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00:15

We had a study that we began back in the '80s called the Diabetes Complication and Control Trial

00:26

or DCCT, and in them we weren't exactly certain what the best level of blood glucose control was.

00:35

And so patients were randomized to so-called standard care versus more intensive blood glucose control.

00:42

And they received either standard therapies or more intensive therapy for a short period of time--

00:49

relatively short, about 7 to 8 years. Just that short period of eight years of intensive-- 7 to 8 years of intensive therapy,

00:56

however, has done two things. First of all, we've actually continued to follow these patients now on an average

01:03

of 27 years in a study called the EDIC trial. That is the Epidemiology of Diabetes Complications.

01:12

And it turns out that this relatively short period of intensive control actually improves the life

01:20

expectancy of people, even with now them being relatively normal.

01:27

It also reduces their chances of developing eye disease or requiring surgery for their eye disease.

01:35

We also find that kidney disease is not as bad in patients who have this short period early

01:42

on in their course of their diabetes with intensive therapy versus others. And we're currently looking to see

01:49

whether cardiovascular or some of the other complications also improve, but what that tells you is that there are some honeymoon period where

01:57

optimal metabolic control has a favorable effect even years

02:04

to decades out towards the future, which really highlights the fact that one of the things that the NIH does quite well

02:12

is follow patients over a very long period of time. This isn't something that the industry is likely to do, get results over 25, 30 years for example.