Strict Glucose Control Reduces CVD Threat

Patients with type 1 diabetes who participatedin the Diabetes Control and ComplicationsTrial experienced a lower risk of heartdisease because of tight glucose control. Themulticenter study evaluated intensive managementof blood glucose and conventionalcontrol in 1441 patients with type 1 diabetes.The participants, aged 13 to 39, were enrolledin the trial between 1983 and 1989.

The patients assigned to intensive treatmentkept glucose levels as near to normal aspossible, with at least 3 insulin injections a dayor an insulin pump, guided by frequent selfmonitoringof blood glucose. The intensivegroup had to keep hemoglobin A^1c levels asclose as possible to the normal value of 6% orless. At the time, conventional treatment consistedof 1 or 2 insulin injections, with dailyurine or blood glucose testing.

The researchers found that, among 1375participants continuing in the study, the intensivelytreated patients had 46 cardiovasculardisease (CVD) events, compared with 98 CVDevents in the conventionally treated group.During the 17 years of follow-up, theresearchers found that 31 intensively treatedpatients (4%) and 52 conventionally treatedpatients (7%) had at least 1 CVD event.