“Control” and Diabetes

For almost 50 years, since insulin therapy was initiated, proponents of "rigid," "tight" or "chemical" control have quoted retrospective evidence of decreased or delayed nephropathy and retinopathy as glucose levels are brought by therapy toward the normal range. Opponents to this hypothesis have pointed to the problems of complications in many of these patients with supposedly better control of the disease, to the emotional and socioeconomic conflicts that often resulted from the demands of rigorous control, to the frequent difficulties with hypoglycemic reactions, and, recently, to the University Group Diabetes Project.1,2Five years ago, in a review of 300 reports . . .