Diabetes--trials, tribulations and pay-off of tight control

In June 1993 the results of the Diabetes Control and Complications Trial (DCCT) were made public. It showed that intensive insulin therapy, designed to produce 'near-normal' blood glucose levels, resulted in a spectacular reduction in long-term risks of all microvascular complications of insulin dependent diabetes mellitus (IDDM) when compared with 'conventional' insulin therapy. On 6 April 1995 a well-attended conference, organised by Professor Stephanie A Amiel, was held at the Royal College of Physicians to discuss the issues arising from the DCCT, the practicalities of implementing change in diabetes care in the light of its results, the benefits and potential risk of such intensive therapy (tight control), the implications of the DCCT findings to patient groups not included in it and other ways of minimising the long-term complications of diabetes.