Medical Dialogues
  • Dermatology
Login Register
This site is intended for healthcare professionals only
Login Register
  • MD Brand Connect
  • Vaccine Hub
  • MDTV
    • Breaking News
    • Medical News Today
    • Health News Today
    • Latest
    • Journal Club
    • Medico Legal Update
    • Latest Webinars
    • MD Shorts
    • Health Dialogues
  • Fact Check
  • Health Dialogues
Medical Dialogues
  • Medical News & Guidelines
      • Anesthesiology
      • Cardiology and CTVS
      • Critical Care
      • Dentistry
      • Dermatology
      • Diabetes and Endocrinology
      • ENT
      • Gastroenterology
      • Medicine
      • Nephrology
      • Neurology
      • Obstretics-Gynaecology
      • Oncology
      • Ophthalmology
      • Orthopaedics
      • Pediatrics-Neonatology
      • Psychiatry
      • Pulmonology
      • Radiology
      • Surgery
      • Urology
      • Laboratory Medicine
      • Diet
      • Nursing
      • Paramedical
      • Physiotherapy
  • Health news
      • Doctor News
      • Government Policies
      • Hospital & Diagnostics
      • International Health News
      • Medical Organization News
      • Medico Legal News
      • NBE News
      • NMC News
  • Fact Check
      • Bone Health Fact Check
      • Brain Health Fact Check
      • Cancer Related Fact Check
      • Child Care Fact Check
      • Dental and oral health fact check
      • Diabetes and metabolic health fact check
      • Diet and Nutrition Fact Check
      • Eye and ENT Care Fact Check
      • Fitness fact check
      • Gut health fact check
      • Heart health fact check
      • Kidney health fact check
      • Medical education fact check
      • Men's health fact check
      • Respiratory fact check
      • Skin and hair care fact check
      • Vaccine and Immunization fact check
      • Women's health fact check
  • AYUSH
    • Ayurveda
    • Homeopathy
    • Siddha
    • Unani
    • Yoga
  • State News
      • Andaman and Nicobar Islands
      • Andhra Pradesh
      • Arunachal Pradesh
      • Assam
      • Bihar
      • Chandigarh
      • Chattisgarh
      • Dadra and Nagar Haveli
      • Daman and Diu
      • Delhi
      • Goa
      • Gujarat
      • Haryana
      • Himachal Pradesh
      • Jammu & Kashmir
      • Jharkhand
      • Karnataka
      • Kerala
      • Ladakh
      • Lakshadweep
      • Madhya Pradesh
      • Maharashtra
      • Manipur
      • Meghalaya
      • Mizoram
      • Nagaland
      • Odisha
      • Puducherry
      • Punjab
      • Rajasthan
      • Sikkim
      • Tamil Nadu
      • Telangana
      • Tripura
      • Uttar Pradesh
      • Uttrakhand
      • West Bengal
  • Medical Education
      • Ayush Education News
      • Dentistry Education News
      • Medical Admission News
      • Medical Colleges News
      • Medical Courses News
      • Medical Universities News
      • Nursing education News
      • Paramedical Education News
      • Study Abroad
  • Industry
      • Health Investment News
      • Health Startup News
      • Medical Devices News
      • Pharma News
      • Pharmacy Education News
      • Industry Perspective
  • MDTV
      • Health Dialogues MDTV
      • Health News today MDTV
      • Latest Videos MDTV
      • Latest Webinars MDTV
      • MD shorts MDTV
      • Medical News Today MDTV
      • Medico Legal Update MDTV
      • Top Videos MDTV
      • Health Perspectives MDTV
      • Journal Club MDTV
      • Medical Dialogues Show
This site is intended for healthcare professionals only
LoginRegister
Medical Dialogues
LoginRegister
  • Home
  • Medical news & Guidelines
    • Anesthesiology
    • Cardiology and CTVS
    • Critical Care
    • Dentistry
    • Dermatology
    • Diabetes and Endocrinology
    • ENT
    • Gastroenterology
    • Medicine
    • Nephrology
    • Neurology
    • Obstretics-Gynaecology
    • Oncology
    • Ophthalmology
    • Orthopaedics
    • Pediatrics-Neonatology
    • Psychiatry
    • Pulmonology
    • Radiology
    • Surgery
    • Urology
    • Laboratory Medicine
    • Diet
    • Nursing
    • Paramedical
    • Physiotherapy
  • Health news
    • Doctor News
    • Government Policies
    • Hospital & Diagnostics
    • International Health News
    • Medical Organization News
    • Medico Legal News
    • NBE News
    • NMC News
  • Fact Check
    • Bone Health Fact Check
    • Brain Health Fact Check
    • Cancer Related Fact Check
    • Child Care Fact Check
    • Dental and oral health fact check
    • Diabetes and metabolic health fact check
    • Diet and Nutrition Fact Check
    • Eye and ENT Care Fact Check
    • Fitness fact check
    • Gut health fact check
    • Heart health fact check
    • Kidney health fact check
    • Medical education fact check
    • Men's health fact check
    • Respiratory fact check
    • Skin and hair care fact check
    • Vaccine and Immunization fact check
    • Women's health fact check
  • AYUSH
    • Ayurveda
      • Ayurveda Giuidelines
      • Ayurveda News
    • Homeopathy
      • Homeopathy Guidelines
      • Homeopathy News
    • Siddha
      • Siddha Guidelines
      • Siddha News
    • Unani
      • Unani Guidelines
      • Unani News
    • Yoga
      • Yoga Guidelines
      • Yoga News
  • State News
    • Andaman and Nicobar Islands
    • Andhra Pradesh
    • Arunachal Pradesh
    • Assam
    • Bihar
    • Chandigarh
    • Chattisgarh
    • Dadra and Nagar Haveli
    • Daman and Diu
    • Delhi
    • Goa
    • Gujarat
    • Haryana
    • Himachal Pradesh
    • Jammu & Kashmir
    • Jharkhand
    • Karnataka
    • Kerala
    • Ladakh
    • Lakshadweep
    • Madhya Pradesh
    • Maharashtra
    • Manipur
    • Meghalaya
    • Mizoram
    • Nagaland
    • Odisha
    • Puducherry
    • Punjab
    • Rajasthan
    • Sikkim
    • Tamil Nadu
    • Telangana
    • Tripura
    • Uttar Pradesh
    • Uttrakhand
    • West Bengal
  • Medical Education
    • Ayush Education News
    • Dentistry Education News
    • Medical Admission News
    • Medical Colleges News
    • Medical Courses News
    • Medical Universities News
    • Nursing education News
    • Paramedical Education News
    • Study Abroad
  • Industry
    • Health Investment News
    • Health Startup News
    • Medical Devices News
    • Pharma News
      • CDSCO (Central Drugs Standard Control Organisation) News
    • Pharmacy Education News
    • Industry Perspective
  • Home
  • Diabetes and Endocrinology
  • Diabetes and Endocrinology Perspective
  • UKPDS and DCCT Legacy...

UKPDS and DCCT Legacy Effects: Importance of Early Treatment of Hyperglycemia

Written By : Dr Shailesh Dixit |Medically Reviewed By : Dr. Kamal Kant Kohli Published On 2023-02-01T12:29:14+05:30  |  Updated On 1 Feb 2023 12:29 PM IST
UKPDS and DCCT Legacy Effects: Importance of Early Treatment of Hyperglycemia
  • facebook
  • twitter
  • linkedin
  • whatsapp
  • Telegram
  • Email

People with diabetes benefit from better target glycemic control in the early years following diagnosis and can prevent threatening vascular complications; a long-term follow-up of the Diabetes Control and Complications Trial (DCCT) and the UK Prospective Diabetes Study (UKPDS) cohorts has reported.

The follow-up of DCCT and UKPDS cohorts, which has been published in Diabetes Care, bring out a direct relationship between all hemoglobin A1c (HbA1c) levels and the risk of complications.

They concluded that a treatment goal of HbA1c less than 7.0 % is realistic and appropriate, and improved glycemic control at this level can reduce several complications associated with diabetes.

Additionally, they predicted that maintaining a 1.0% decrease in HbA1c from diagnosis might lower the risk of death by 19% as opposed to 2.7% when the same improvement was delayed for ten years.

DCCT and UKPDS Unveil Key Insights to Glycemic Control Management:

The DCCT and UKPDS provide further details on earlier accounts of the long-term implications of a brief glycemic control period.

They explored the contribution, effects, and preventive measures of complications associated with diabetes, integrating the necessity of keeping the HbA1c level below 7%.

The DCCT sought to evaluate the favourable benefits of intensive therapy on individuals with type 1 diabetes' risk of cardiovascular disease.

The trial enrolled young people with type 1 diabetes (mean age 26 years) for an average of 6 years. Over 6.5 years, the randomised treatment phase maintained an HbA1c difference of about 2.0%. The progression of new or existing retinopathy was the endpoint. Due to the ageing of the population, there were too few cardiovascular events to analyse.

In contrast, the UKPDS conducted a randomised controlled trial to examine the impact of intensive blood-glucose management with either sulphonylurea or insulin and conventional care on the risk of microvascular and macrovascular problems in patients with type 2 diabetes.

Within a year of type 2 diabetes diagnosis, the UKPDS enrolled an older population (mean age 56 years), randomising individuals with increased fasting plasma glucose after three months of lifestyle management. HbA1c levels in both arms gradually worsened over the course of ten years, although the between-treatment difference remained at about 1.0%. Composites of medical events, such as any diabetes-related event (including cardiovascular and microvascular outcomes), deaths from diabetes-related causes, and deaths from any cause, were the major end points utilised to evaluate treatment differences.

Targets for Glycemic Control: General Consensus Reached from landmark DCCT/EDIC &UKPDS

Despite their variations, the research' similar methods for long-term follow-up enable the building of a simple model of the natural history of outcomes associated with diabetes, which links glycemic control to late complications.

  • The UKPDS and the DCCT showed that near normoglycemia might significantly slow the onset and progression of microvascular complications.
  • The DCCT and the UKPDS noted clinical decreases in cardiovascular diseases linked to reducing blood glucose levels.
  • They predicted that maintaining a 1.0% decrease in HbA1c from diagnosis might lower the risk of death by 19% as opposed to 2.7% when the same improvement was delayed for ten years.

The DCCT/EDIC and UKPDS investigators concurred that limiting problems in later years begins in the first few years following a diabetes diagnosis.

This accentuates a crucial clinical point strongly. Good glycemic control must begin early and be maintained for a long time. Both type 1 and type 2 diabetes would benefit with such treatment goals.

Hyperglycemia can cause damage at the molecular level (glycated hemoglobin, other modified proteins, partial methylated nucleotides), tissue injuries (retinal vessels, partial glomerular, partial nerve fibers, partial arterial wall damage), organ dysfunction (reduced visual acuity, reduced eGFR, limited peripheral neuropathy, impaired cardiac performance), clinical events (vision loss, kidney failure, foot ulceration, stroke, myocardial infarct, heart failure), and late impairments (frailty, reduced mobility, progressive cognitive decline). Cumulative damage to multiple organs eventually leads to impaired quality of life and mortality.
Diabetes has reached epidemic proportions and is one of the leading causes of premature morbidity and mortality worldwide. Patients with diabetes have long suffered from the devastating complications that threaten their lives.
Evidence from the DCCT and UKPDS demonstrated the continuous link between prevailing glycemia and the likelihood of complications progressing, suggesting that any improvement in glycemic control is advantageous.

To take advantage of these advances, it is important to pursue appropriate glycemic control, prevent both hyper- and hypoglycemia, and establish an individualised approach for diabetes patients to reach their target HbA1c levels.

References:
1. Riddle MC, Gerstein HC, Home PD. Lingering Effects of Hyperglycemia in Recently Diagnosed Diabetes During Long-term Follow-up of the DCCT/EDIC and UKPDS Cohorts: More Evidence That Early Control Matters [published online ahead of print, 2021 Sep 21]. Diabetes Care. 2021;dci210030. doi:10.2337/dci21-0030
2. Nathan DM, Cleary PA, Backlund J-YC, et al.; Diabetes Control and Complications Trial/ Epidemiology of Diabetes Interventions and Complications (DCCT/EDIC) Study Research Group. Intensive diabetes treatment and cardiovascular disease in patients with type 1 diabetes. N Engl J Med 2005;353:2643–2653
3. UK Prospective Diabetes Study (UKPDS) Group. Intensive blood-gluco se control with sulphonylureas or insulin compared with conventional treatment and risk of complications in patients with type 2 diabetes (UKPDS 33). Lancet 1998;352:837–853
hba1chba1c less than 7hba1c levelsglycemic indexDiabetes CareDCCT/EDIC studyukpds trialtype2 diabetesT2DMdiabetic microvascular complicationsdiabetic macrovascular complicationshypoglycemiaHyperglycemiaglycemic targets
Dr Shailesh Dixit
Dr Shailesh Dixit

    Dr Shailesh Dixit, MBBS, MD, is a Senior Consultant Diabetologist & Physician at SMS Hospital and Medical College, Jaipur. Dr Dixit has more than 28 years of experience in the field of Diabetes and Medicine.

    Dr. Kamal Kant Kohli
    Dr. Kamal Kant Kohli

    Dr Kamal Kant Kohli-MBBS, DTCD- a chest specialist with more than 30 years of practice and a flair for writing clinical articles, Dr Kamal Kant Kohli joined Medical Dialogues as a Chief Editor of Medical News. Besides writing articles, as an editor, he proofreads and verifies all the medical content published on Medical Dialogues including those coming from journals, studies,medical conferences,guidelines etc. Email: drkohli@medicaldialogues.in. Contact no. 011-43720751

    Show Full Article
    Next Story

    Editorial

    Vestibular Migraine: Clinical Update and Role of Buccal Prochlorperazine

    Vestibular Migraine: Clinical Update and Role of Buccal Prochlorperazine

    U.S. FDA Drug Safety Alert: Warning Issued for Severe Itching After Stopping Long-Term Cetirizine or Levocetirizine Use

    U.S. FDA Drug Safety Alert: Warning Issued for Severe Itching After Stopping Long-Term Cetirizine or...

    Aspirin in Primary Prevention: Prudent Guideline-Based Approach

    Aspirin in Primary Prevention: Prudent Guideline-Based Approach

    Prediabetes and CKD: An Overlooked Interaction in Early Metabolic Disease

    Prediabetes and CKD: An Overlooked Interaction in Early Metabolic Disease

    Environmental Impact on Seborrheic Dermatitis, Tinea versicolor and Dandruff: The Role of Selenium Sulfide in Seborrheic Dermatitis Management

    Environmental Impact on Seborrheic Dermatitis, Tinea versicolor and Dandruff: The Role of Selenium...

    View All

    Journal Club Today

    Cochrane Review Shows Virtual Reality May Help Regain Arm Movement in Stroke Survivors

    Cochrane Review Shows Virtual Reality May Help Regain Arm Movement in Stroke Survivors

    View All

    Health News Today

    Health Bulletin 23/June/2025

    Health Bulletin 23/June/2025

    View All
    © 2022 All Rights Reserved.
    Powered By: Hocalwire
    X
    We use cookies for analytics, advertising and to improve our site. You agree to our use of cookies by continuing to use our site. To know more, see our Cookie Policy and Cookie Settings.Ok