Perspectives in Diabetes Lessons From the Diabetes Control and Complications Trial

issues are being prepared. Most importantly, soon after each of these results are published, the DCCT plans to 0 n 13 June 1993, the results of the Diabetes Control and Complications Trial were an- nounced during the annual scientific meeting of the American Diabetes Association in Las Vegas, Nevada. After more than a decade of careful planning, much hard work, and perseverance, the results, were both clear and dramatic, Intensively managed 13-'fo 39-yr-old IDDM patients maintained (for 4-9 yr at-50 gldl [2.8 mM]) lower mean blood glucose levels than fa'rly well controlled, conventionally treated patients and ha a substantial reduction in the development or pro-gre 2 sion of retinopathy, nephropathy, and neuropathy as well as a likely reduction in macrovascular complications of diabetes. These benefits outweighed a threefold in-crease in the risk of severe hypoglycemia and modest excess \weight gain observed in intensively managed patients. As Dr. Oscar Crofford informed the patient volunteers several days before the public announcement of the main DCCT results, the early termination of the trial was only the "end of the beginning. " The study describing the main DCCT results has been published (1). More de-tailed results of the ocular, renal, neurological, and macrovascular aspects of the trial, and additional reports on treatment implementation, quality of life, neurobehav-ioral effects, pregnancy, adolescent control, and othe