Part1 - Part2 - Part3 - Part4 - Part5 - Single Page

Top Document: diabetes FAQ: research (part 5 of 5)
Previous Document: More details about the DCCT
Next Document: Who did this?


[ Usenet FAQs | Search | Web FAQs | Documents | RFC Index ]

DCCT philosophy: what did it really show?


It is often stated that the DCCT proved that tight control or lowered
HbA1c reduces complications. This is not the case. The controlled
variable in the DCCT was intensive vs conventional therapy, and
intensive therapy was defined by several factors including a team of
skilled health care professionals acting in partnership with the
patient. The results show that intensive therapy results in both
lowered HbA1c and fewer complications, but do not show that one causes
the other. The lead authors provide a good summary of this point in a
followup (NEJM 330:642, March 3, 1994):

    We want to stress that the most valid interpretation of the trial
    is that intensive therapy, with the **goal** of achieving blood
    glucose concentrations as close to the nondiabetic range as
    possible, delays the onset and slows the progression of long-term
    diabetic complications. The secondary analyses support the notion
    that lower glycosylated hemoglobin values are associated with a
    lower risk of progression of retinopathy, but they do not prove
    that hyperglycemia in itself causes retinopathy. [emphasis added]

Many of us believe, and believed before the DCCT, that actually
achieving good control aids our health. The DCCT adds weight to this
case but does not prove the point.



Top Document: diabetes FAQ: research (part 5 of 5)
Previous Document: More details about the DCCT
Next Document: Who did this?

Part1 - Part2 - Part3 - Part4 - Part5 - Single Page


[ Usenet FAQs | Search | Web FAQs | Documents | RFC Index ]

Send corrections/additions to the FAQ Maintainer:
edward@paleo.org

Last Update May 13 2007 @ 00:22 AM