Sunday, June 12, 2005

Startling News!

Just came out of the late-breaking clinical trial symposium where there were a couple of startling studies reported. I'll save the best news for last...

First the results of the Diabetes Prevention Program. You may recall that this is a study looking at whether lifestyle modification (weight loss and exercise) in people with pre-diabetes could slow down the progression of diabetes and its complications. Indeed it does. For the first time they showed that there were complications of diabetes seen in people with pre-diabetes. Pre-diabetes seems more and more to be not just an omen for the development of diabetes but in itself is a serious condition.

But the biggest news of all is the follow-up study of the Diabetes control and Complications Trial (DCCT). You might recall that this was a study that showed that intensive glucose control reduced the rate of kidney disease, blindness, neuropathy and amputation. The trial ended some ten years ago but the people enrolled in the trial were continued to be followed. During the trial the control group's A1c was about 9 and the experimental group was at 7%. With a year and a half after the trial both groups came together and had an A1c of about 8 and they maintained that similar A1c for the duration of the 10 years of follow-up. The startling news is that brief period of intensive control - 6 years of intensive control - resulted in nearly a 50% drop in cardiovascular events, cardiovascular mortality, strokes, everything to do with cardiovascualar disease.

This is a huge story that will be covered in the newspapers. Early intensive control of blood glucose even for short periods of time results in a marked reduction of cardiovascular disease.

This may be the greatest therapy of all for people with diabetes. Have intensive glucose control - as good as possible and as early as possible in the progression of the disease - and you may significantly reduce your risk for cardiovascular disease.