scholarly journals Understanding Metabolic Memory: The Prolonged Influence of Glycemia During the Diabetes Control and Complications Trial (DCCT) on Future Risks of Complications During the Study of the Epidemiology of Diabetes Interventions and Complications (EDIC)

Diabetes Care ◽  
2021 ◽  
Vol 44 (10) ◽  
pp. 2216-2224 ◽  
Author(s):  
John M. Lachin ◽  
David M. Nathan
Keyword(s):  
Diabetes Control ◽  
Metabolic Memory ◽  
Diabetes Interventions

scholarly journals Understanding Metabolic Memory: The Prolonged Influence of Glycemia During the Diabetes Control and Complications Trial (DCCT) on Future Risks of Complications During the Study of the Epidemiology of Diabetes Interventions and Complications (EDIC)

2021 ◽  
Author(s):  
John M. Lachin ◽  
David M. Nathan ◽  
the DCCT/EDIC Research Group
Keyword(s):  
Conventional Therapy ◽  
Microvascular Complications ◽  
Intensive Therapy ◽  
Diabetes Control ◽  
Metabolic Memory ◽  
Beneficial Effects ◽  
Legacy Effect ◽  
Hba1c Levels ◽  
Diabetes Interventions

The Diabetes Control and Complications Trial (DCCT, 1983-1993) showed that intensive therapy (mean HbA1c 7.2%) compared with conventional therapy (mean HbA1c 9.0%) markedly reduced the risks of retinopathy, nephropathy and neuropathy, and these reductions in complications were entirely attributable, statistically, to the difference in mean HbA1c levels. The DCCT cohort has been followed in the Epidemiology of Diabetes Interventions and Complications study (EDIC, 1994 to date). <p>Early in EDIC, mean HbA1c levels in the former intensively and conventionally treated groups converged. Nevertheless, the beneficial effects of DCCT intensive versus conventional therapy on microvascular complications not only persisted but increased during EDIC. The differences in complications during EDIC were wholly explained, statistically, by differences between groups in HbA1c levels during DCCT. These observations give rise to the concept of metabolic memory. Subsequent similar findings from the UKPDS gave rise to a similar concept, which they called the legacy effect. </p> <p>In this report, we present the evidence to support metabolic memory as both a biological and epidemiological phenomenon, and discuss potential underlying mechanisms. We also compare metabolic memory and the legacy effect and conclude that the two are likely biologically similar, with comparable effects on long-term outcomes.</p> <p>The long-term influence of metabolic memory on the risk of micro- and macrovascular complications supports the implementation of intensive therapy, with the goal of maintaining near normal levels of glycemia, as early and as long as safely possible in order to limit the risk of complications.</p>

scholarly journals Understanding Metabolic Memory: The Prolonged Influence of Glycemia During the Diabetes Control and Complications Trial (DCCT) on Future Risks of Complications During the Study of the Epidemiology of Diabetes Interventions and Complications (EDIC)

2021 ◽  
Author(s):  
John M. Lachin ◽  
David M. Nathan ◽  
the DCCT/EDIC Research Group
Keyword(s):  
Conventional Therapy ◽  
Microvascular Complications ◽  
Intensive Therapy ◽  
Diabetes Control ◽  
Metabolic Memory ◽  
Beneficial Effects ◽  
Legacy Effect ◽  
Hba1c Levels ◽  
Diabetes Interventions

The Diabetes Control and Complications Trial (DCCT, 1983-1993) showed that intensive therapy (mean HbA1c 7.2%) compared with conventional therapy (mean HbA1c 9.0%) markedly reduced the risks of retinopathy, nephropathy and neuropathy, and these reductions in complications were entirely attributable, statistically, to the difference in mean HbA1c levels. The DCCT cohort has been followed in the Epidemiology of Diabetes Interventions and Complications study (EDIC, 1994 to date). <p>Early in EDIC, mean HbA1c levels in the former intensively and conventionally treated groups converged. Nevertheless, the beneficial effects of DCCT intensive versus conventional therapy on microvascular complications not only persisted but increased during EDIC. The differences in complications during EDIC were wholly explained, statistically, by differences between groups in HbA1c levels during DCCT. These observations give rise to the concept of metabolic memory. Subsequent similar findings from the UKPDS gave rise to a similar concept, which they called the legacy effect. </p> <p>In this report, we present the evidence to support metabolic memory as both a biological and epidemiological phenomenon, and discuss potential underlying mechanisms. We also compare metabolic memory and the legacy effect and conclude that the two are likely biologically similar, with comparable effects on long-term outcomes.</p> <p>The long-term influence of metabolic memory on the risk of micro- and macrovascular complications supports the implementation of intensive therapy, with the goal of maintaining near normal levels of glycemia, as early and as long as safely possible in order to limit the risk of complications.</p>

scholarly journals INTERPRETACIÓN DE DATOS EN EL MONITOREO CONTINUO DE GLUCOSA. RECOMENDACIONES PARA LA INDICACIÓN

2020 ◽  
Vol 53 (2Sup) ◽  
pp. 20
Author(s):  
Gabriela Rovira
Keyword(s):  
Diabetes Mellitus ◽  
Diabetes Control ◽  
Diabetes Interventions

El monitoreo glucémico es un pilar fundamental en el tratamiento del paciente con diabetes. Estudios epidemiológicos como el Diabetes Control and Complications Trial y el Epidemiology of Diabetes Interventions and Complications (DCCT/EDIC) demostraron que para mejorar el grado de control metabólico en los pacientes con diabetes mellitus tipo 1 (DM1) mediante el tratamiento intensivo con cualquiera de las modalidades de insulinoterapia (MDI, múltiples dosis de insulina subcutánea; ISCI, infusión subcutánea continua de insulina) se requieren frecuentes medidas de glucemia capilar al día y emplear esta información para efectuar modi caciones en el tratamiento.

scholarly journals Self-Reported Autoimmune Disease by Sex in the Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications (DCCT/EDIC) Study

Diabetes Care ◽  
2014 ◽  
Vol 37 (2) ◽  
pp. e28-e29 ◽  
Author(s):  
E. Buschur ◽  
A. V. Sarma ◽  
M. Pietropaolo ◽  
R. L. Dunn ◽  
B. H. Braffett ◽  
...  
Keyword(s):  
Autoimmune Disease ◽  
Diabetes Control ◽  
Diabetes Interventions

scholarly journals Hearing Impairment and Type 1 Diabetes in the Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications (DCCT/EDIC) Cohort

Diabetes Care ◽  
2018 ◽  
Vol 41 (12) ◽  
pp. 2495-2501 ◽  
Author(s):  
David S. Schade ◽  
Gayle M. Lorenzi ◽  
Barbara H. Braffett ◽  
Xiaoyu Gao ◽  
Kathleen E. Bainbridge ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Hearing Impairment ◽  
Diabetes Control ◽  
Diabetes Interventions

scholarly journals Haptoglobin Genotype and the Rate of Renal Function Decline in the Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications Study

Diabetes ◽  
2013 ◽  
Vol 62 (9) ◽  
pp. 3218-3223 ◽  
Author(s):  
Trevor J. Orchard ◽  
Wanjie Sun ◽  
Patricia A. Cleary ◽  
Saul M. Genuth ◽  
John M. Lachin ◽  
...  
Keyword(s):  
Renal Function ◽  
Diabetes Control ◽  
Renal Function Decline ◽  
Haptoglobin Genotype ◽  
Diabetes Interventions
Sign in / Sign up

Export Citation Format

Share Document