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[IP] clarification re the DCCT

> From: email @ redacted
> Subject: Re: [IP] Re: Optimism re diabetes
> Lori, the DCCT results show that there is a strong correlation between A1C
> and complications. The lower the A1C, the fewer the complications, and this
> correlation extends right down into the normal range.  The DCCT was
> done with long acting insulins and multiple injections, and although it is
> possible to get low A1c's with this, everyone on this list knows better.
> I bet 90% of the pumpers on this list have A1Cs lower than 90% of the
> people in that long term DCCT study.   And I bet the frequency of
> complications among the thousands of conscientious pumpers will be much
> lower than in the DCCT.
> If you stop to examine the DCCT study, you will find that 40% of
> the group that made herculean efforts at tight control -- including
> monthly visits to endocrinologist, CDnurseE, dietitian, and social
> worker (that's all 4, every month) -- still had severe, debilitating
> complications occur.

A few points regarding the DCCT:

1.    It's not "we" on the list vs. "they" in the study.  Many of us who were
DCCT participants are here on this list.  I, for one, was randomized into the
standard treatment group (2 shots per day), then switched to MDI, followed by the
pump, after the conclusion of the study.  Like many of the others on this list, I
am also a participant in EDIC, the follow-up study for the DCCT.

2.    Actually, people in the experimental group (tight control) had the option
of using MDI or insulin pumps, so many of them (most?) did use pumps for the

3.    I don't know the source of the statistic that "40% of the experimental
group had severe, debilitating complications", but I think it's simply untrue.  I
guess it may be influenced by one's personal definition of "severe, debilitating

I think it's pretty clear that tight control, while not a guarantee, is the best
bet we have right now.


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