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Patients with type 1 diabetes who participated in the Diabetes Control and Complications Trial experienced a lower risk of heart disease because of tight glucose control. The multicenter study evaluated intensive management of blood glucose and conventional control in 1441 patients with type 1 diabetes. The participants, aged 13 to 39, were enrolled in the trial between 1983 and 1989.
The patients assigned to intensive treatment kept glucose levels as near to normal as possible, with at least 3 insulin injections a day or an insulin pump, guided by frequent selfmonitoring of blood glucose. The intensive group had to keep hemoglobin A1c levels as close as possible to the normal value of 6% or less. At the time, conventional treatment consisted of 1 or 2 insulin injections, with daily urine or blood glucose testing.
The researchers found that, among 1375 participants continuing in the study, the intensively treated patients had 46 cardiovascular disease (CVD) events, compared with 98 CVD events in the conventionally treated group. During the 17 years of follow-up, the researchers found that 31 intensively treated patients (4%) and 52 conventionally treated patients (7%) had at least 1 CVD event.