U.S. Department of Health and Human Services

Intensive Blood Glucose Control Reduces Kidney Disease

New results show that controlling blood glucose early in the course of type 1 diabetes yields huge dividends, preserving kidney function for decades. The landmark Diabetes Control and Complications Trial (DCCT) began in 1983, but because it can take years for early signs of diabetes complications to develop, it was not until 1993 that sufficient time had passed for the trial to prove that intensive blood glucose control reduced early signs of kidney dysfunction and other complications in people with type 1 diabetes. However, because more serious impairment of kidney function or kidney disease can take even longer to develop, researchers could not determine the effect of intensive therapy on the development of kidney disease at that time. DCCT participants were invited to join the DCCT follow-up, the Epidemiology of Diabetes Interventions and Complications (EDIC) study, and today, nearly 3 decades after the start of the DCCT, about 95 percent of DCCT participants continue to be followed to determine the long-term effects of the therapies beyond the initial treatment period. Now, after an average 22-year follow-up, EDIC researchers reported that controlling blood glucose can prevent loss of kidney function and is likely to reduce kidney failure. Compared to conventional therapy, near-normal control of blood glucose—beginning soon after diagnosis of type 1 diabetes and continuing an average 6.5 years—reduced the long-term risk of developing kidney disease by 50 percent. This finding—along with previous DCCT/EDIC research demonstrating the benefit of intensive blood glucose control in reducing the risk of eye, nerve, and cardiovascular complications— reinforces the importance of early, intensive blood glucose control in people with type 1 diabetes. DCCT and EDIC illustrate the value of long-term studies, have revolutionized disease management, and led to greatly improved outcomes for people with type 1 diabetes. 

de Boer IH, Sun W, Cleary PA, et. al. Intensive diabetes therapy and glomerular filtration rate in type 1 diabetes. N Engl J Med 365: 2366-2376, 2011.