ISSN 1662-4009 (online)

ESPE Yearbook of Paediatric Endocrinology (2018) 15 10.12 | DOI: 10.1530/ey.15.10.12

Diabetes Control and Complications Trial (DCCT)/Epidemiology of Diabetes Interventions and Complications (EDIC) Research Group Case Western Reserve University, Cleveland, OH, USA


To read the full abstract: Diabetes Care. 2017;40:1010-1016

Professor Tamberlane and co-workers investigated the rates of severe hypoglycemia in the DCCT/Epidemiology of Diabetes Interventions and Complications (EDIC) cohort after approximately 30 years of follow-up. In earlier studies, high rates of hypoglycemic episodes had been found to be associated with lower HbA1c levels and intensified insulin treatment strategies. Now, in this reanalysis and extensive follow-up of a sub-cohort of the initial DCCT cohort, it has become clear that rates of severe hypoglycemia equilibrated over time between the two DCCT/EDIC treatment groups, hence conventional and intensified treatment arms in association with advancing duration of diabetes and similar HbA1c levels.

The authors rightfully acknowledge that severe hypoglycemia persists and remains a challenge for patients with T1DM across their life span. However, it has become very clear that good glycemic control does not lead to more severe and more frequent hypoglycemia. In fact, good metabolic control as shown by low HbA1c levels is associated with lower risk for both hypoglycemia and ketoacidosis. It is assumed that this might be most likely to education and high adherence to treatment protocols as well as due to frequent blood glucose measurements.

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