Heart complications of diabetes can also be prevented with intensive treatment. The Epidemiology of Diabetes Interventions and Complications Study (EDIC) has continued to follow the participants in the DCCT. EDIC investigators recently reported that intensive control lowers the risk of heart disease and stroke by about 50 percent. These findings underscore the importance of good control of blood sugar in the short and long term. Again, these findings in type 1 diabetes patients have been replicated in type 2 diabetes patients as well, because both forms of the disease share the same possible complications in terms of damage to the kidneys, eyes, nerves, heart, and other organs.

The results of this trial underscore the fact that because of pioneering research in type 1 diabetes, close control of blood glucose levels is now a keystone to the medical management of both forms of the disease. Moreover, this landmark trial in type 1 diabetes also established the value of hemoglobin A1c (HbA1c) levels -- a measurement of blood glucose levels over time -- as an outcome measure for future clinical trials in both type 1 and type 2 diabetes, dramatically shortening the cost and duration of new trials of new therapies and encouraging development of new therapies of diabetes. The use of HbA1c as an outcome measure was the basis for approval of improved forms of injected insulin, inhaled insulin, and several new classes of oral drugs for type 2 diabetes, which used in combination can delay the need for insulin therapy.

Figure adapted from N Engl J Med 353: 2643-2653, 2005.