Aggressive therapy benefits diabetic patients

February 9, 2000
Web posted at: 5:34 p.m. EST (2234 GMT)

From staff and wire reports

(CNN) -- Physicians routinely advise diabetic patients taking insulin to check blood-glucose levels frequently, exercise regularly and maintain a strict diet. A medical study released Wednesday found that benefits from this aggressive therapy is long-lasting.

Less eye and kidney disease -- common complications from diabetes -- was among the benefits continuing at least four years after intensive therapy, reported The New England Journal of Medicine in its February 10 edition.

Although the study may have implications for all people with diabetes, the research examined patients with Type 1 diabetes, which typically develops in children and young adults who then become insulin dependent. Type 2 diabetes, which affects a far larger number of people, usually begins when patients are middle age, and many don't become insulin dependent.

	VIDEO
CNN's Holly Firfer reports the treatments can help only if patients follow them. Real 28K 80K Windows Media 28K 80K

The researchers followed about 1,300 patients who had participated in the Diabetes Control and Complications Trial, conducted between 1983 and 1993. Some of the patients had conventional therapy, consisting of one or two insulin injections per day with one urine or blood-glucose test per day.

The other patients took a more aggressive approach. It included at least three daily injections of insulin or treatment with an insulin pump. Dosages were adjusted frequently based on at least four blood-glucose tests per day -- plus diet and exercise.

Four years after the trial was completed, Dr. David Nathan of the Massachusetts General Hospital and his colleagues found that risk of vision complications from diabetes was significantly lower among the people who had been treated aggressively.

This was true even though some patients who originally received aggressive treatment had become lax in controlling their diabetes.

"After four additional years of follow-up, the rate of worsening of complications did not increase in the intensive-therapy group," the physicians concluded.

Likewise, the proportion of kidney complications measured three and four years after the original study was "nearly twice as high" in the conventional-treatment group compared to the patients treated more aggressively.

Nathan and his team members said the "findings strongly support the implementation of intensive therapy as early as is safely possible and the maintenance of such therapy for as long as possible."

However, they cautioned, the results "should not be interpreted to mean that intensive therapy needs to be administered for only a limited period of time."

Dr. Suzanne Gebhart, an Atlanta endocrinologist, said new treatments like an insulin inhaler and blood-glucose monitoring devices that don't require pricking skin will be developed, making the control of diabetes easier. For now, however, family support remains a strong ally for all people with diabetes, she said.

"Family members who can be on the team, who can help make life easier by encouraging compliance, really, really make a big difference," Dr. Gebhart said.

CNN Health Correspondent Holly Firfer and Reuters contributed to this report.

Researchers find new way to deliver insulin in lab studies
February 4, 2000
Exercise may reduce diabetics risk for heart disease, study says
January 12, 2000
FDA advisers recommend diabetes wristwatch
December 7, 1999

American Diabetes Association
National Institute of Diabetes and Digestive and Kidney Diseases
Juvenile Diabetes Association

Note: Pages will open in a new browser window

External sites are not endorsed by CNN Interactive.