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Renewal of Epidemiology of Diabetes Interventions and Complications (EDIC) (Renewal)

January 2026 Council

Lead Division/Office

DEM

Point(s) of Contact

Jean M. Lawrence, Sc.D., M.P.H., M.S.W.

Executive Summary

The Diabetes Control and Complications Trial (DCCT, 1983-1993) compared intensive (aimed at near-normal glycemia) and conventional therapy in 1,441 participants with T1D over a mean of 6.5 years. Results, reported in 1993, demonstrated the benefits of intensive (mean HbA1c ~7%) compared with conventional therapy (HbA1c ~9%) in reducing the risk of development and progression of microvascular complications by 35-76%. As a result, HbA1c <7% was adopted worldwide as the therapeutic target for T1D.

The Epidemiology of Diabetes Interventions and Complications (EDIC, 1994-present) study was initiated as an observational follow-up of the DCCT cohort. EDIC has shown that the early beneficial effects of intensive versus conventional therapy on complications persisted for ~10 years after convergence of HbA1c levels in the two groups. This observation has been termed “metabolic memory.” Prior intensive therapy was also shown to reduce the risk of severe microvascular complications, cardiovascular disease, mortality and, recently, age-related outcomes including cognitive impairment, bone loss, and reduced mobility.

The DCCT/EDIC cohort is the most extensively studied T1D cohort in history. The participants have been followed and deeply phenotyped for 95% of their diabetes durations and 65% of their lifespans. Throughout its 40+ years, DCCT/EDIC has generated results guiding T1D treatment priorities and led to improved survival and quality-of-life for millions with T1D worldwide.