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Epidemiology of Diabetes Interventions and Complications (EDIC) – Continuation of Core Activities

May 2020 Council

Lead Division/Office

DEM

Point(s) of Contact

Ellen Leschek, M.D.

Executive Summary

In 1993, after the Diabetes Control and Complications Trial (DCCT) showed that intensive type 1 diabetes (T1D) therapy delayed the onset and progression of microvascular complications, EDIC began to study the long-term effects of DCCT treatment assignment and assess the effects of longstanding disease on complication development and progression.

EDIC has shown persistence of the microvascular, cardiovascular and mortality benefits of DCCT intensive therapy (metabolic memory). New complications have been explored (e.g. urological conditions, gastroparesis, cheiroarthropathy, hearing loss, cognitive/physical dysfunction, skeletal health), new methodologies for complications have been studied (e.g. cardiac MRI, coronary artery calcium scoring), and guidelines for microvascular screening have been proposed.

Currently >92% of the surviving cohort is followed in EDIC. In the new grant cycle, the cohort will continue to be studied for cognitive and physical dysfunction, advanced microvascular complications and cardiovascular disease and mortality. Exciting new measures will be added, such as OCT angiography and echocardiography. The rate of complications is accelerating as this dedicated cohort ages. EDIC is uniquely poised to complement ongoing study measures with important age and T1D-relevant assessments focusing on heart failure and systolic and diastolic dysfunction as well as obesity/type 2 diabetes physiology (NASH, NAFLD, obstructive sleep apnea) in longstanding T1D.