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.
Treatments for type 1 diabetes-- let me start with that-- have actually improved quite greatly.
We had a study that we began back in the '80s called the Diabetes Complication and Control Trial
or DCCT, and in them we weren't exactly certain what the best level of blood glucose control was.
And so patients were randomized to so-called standard care versus more intensive blood glucose control.
And they received either standard therapies or more intensive therapy for a short period of time--
relatively short, about 7 to 8 years. Just that short period of eight years of intensive-- 7 to 8 years of intensive therapy,
however, has done two things. First of all, we've actually continued to follow these patients now on an average
of 27 years in a study called the EDIC trial. That is the Epidemiology of Diabetes Complications.
And it turns out that this relatively short period of intensive control actually improves the life
expectancy of people, even with now them being relatively normal.
It also reduces their chances of developing eye disease or requiring surgery for their eye disease.
We also find that kidney disease is not as bad in patients who have this short period early
on in their course of their diabetes with intensive therapy versus others. And we're currently looking to see
whether cardiovascular or some of the other complications also improve, but what that tells you is that there are some honeymoon period where
optimal metabolic control has a favorable effect even years
to decades out towards the future, which really highlights the fact that one of the things that the NIH does quite well
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.
living with diabetes
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