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The symptoms of hyperglycemia in diabetics can usually be controlled without achieving normoglycemia. Whether more intensive therapy can prevent microvascular, macrovascular, and neurologic complications has been unclear. The long- awaited results of the Diabetes Control and Complications Trial address this question.
The multicenter study randomized 1441 patients with mild or no retinopathy (average age, 27) to intensive or conventional therapy. Intensive therapy involved an insulin pump or at least 3 daily insulin injections guided by at least 4 daily blood sugar measurements; conventional therapy involved 1 to 2 daily injections, usually without daily dose adjustments. Patients were followed for a mean of 6.5 years.
Patients receiving inten…