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Intensive Control of Type 1 Diabetes Helps Kidneys: Study
Date:11/13/2011

from the Diabetes Control and Complications Trial (DCCT) and the Epidemiology of Diabetes Interventions and Complications (EDIC) study. The DCCT included more than 1,400 people with type 1 diabetes who were randomly assigned to receive either intensive diabetes management or conventional diabetes therapy at the time (1980s). The average time since diagnosis with diabetes was about six years when the study started.

Intensive management was aimed at lowering hemoglobin A1C levels (HbA1C) to less than 6.05 percent. HbA1C is a long-term (about two to three months) measurement of blood sugar levels, and levels below 6.05 percent are similar to levels for people who don't have diabetes. Lower numbers generally translate into a lower risk of serious complications.

The DCCT lasted for 6.5 years, and the EDIC trial is an observational study that has followed the health of 1,375 participants since the DCCT ended. EDIC currently has 16 years of follow-up data.

During the DCCT, people in the intensive management group averaged an HbA1C of 7.3, while the conventional group had an HbA1C average of 9.1 percent. During EDIC, both groups had HbA1Cs around 8 percent, according to de Boer.

The current analysis looked specifically at the glomerular filtration rate, which is a measure of how well kidneys function.

The researchers found that 24 people in the intensive therapy group developed an impaired GFR, compared with 46 people in the conventional therapy group.

"That's a risk reduction of 50 percent," said de Boer.

The risk of end-stage renal disease in the intensive therapy group was also half that of the conventional therapy group -- eight people versus 16.

"Getting good glucose control up front in the disease course provides benefits immediately and in preventing complications for years to come," de Boer said. "The longer you're able to maintain good glucose control, the more benefit you're likely to derive."

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