DCCT: intensive control reduces renal risk

The latest follow-up data from the Diabetes Control and Complications Trial (DCCT) shows that 6.5 years of intensive glycaemic control halves the risk of renal impairment 16 years later (NEJM 2011; doi: 10.1056/NEJMoa1111732).

    DCCT randomised 1441 people with type 1 diabetes to intensive treatment to achieve near-normal glucose levels or to conventional therapy to prevent hyperglycaemic symptoms. The trial ended after 6.5 years but the latest report – with analysis of the subsequent observational study representing a total of 22 years’ follow-up – shows that the benefits of tight glycaemic control are long lasting.
    The lower risk of renal impairment was not evident for 10 years. Impaired glomerular filtration rate (GFR, <60ml per minute per 1.73m2) occurred in 24 people assigned to intensive therapy and 46 who received conventional therapy. The number needed to treat for 6.5 years to prevent one case of impaired GFR over a period of 20 years was 29. End-stage renal disease developed in 8 and 16 patients respectively.