Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications (DCCT/EDIC)

It is well established that people with diabetes have an increased risk of cardiovascular disease and cardiovascular death compared to people without diabetes. Until recently there has been a lack of information on cardiovascular risk reduction in people with type 1 diabetes, especially the younger population. Previous studies looking specifically at glycaemic control have been few in number and the results inconsistent. The DCCT trial demonstrated that a period of intensive insulin therapy and improvement in HbA 1c % reduced the incidence and progression of microvascular complications, but macrovascular events were not significantly reduced. The DCCT/EDIC study was the long‐term observational follow up of patients from DCCT, and was used to evaluate whether intensive therapy reduced cardiovascular events in patients with type 1 diabetes. The patients treated intensively in the original DCCT trial had a 42% reduction in any first cardiovascular event when compared to the conventionally treated group, and the risk of first occurrence of non‐fatal myocardial infarction, stroke or death from cardiovascular disease was reduced by 57%. DCCT/EDIC provides us with long‐term, objective documentation of glycaemic control and its relationship to cardiovascular complications. However, until we find methods of bringing down HbA 1c % without the added problem of frequent hypoglycaemia, we may find it difficult to translate these findings into our everyday practice.