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[IP] Might the DCCT have been flawed?



I read the quote that follows this morning and it brought up the question - 
Did it DCCT take into account the psychological impact of the additional 
professional support that the experimental group received (the group that 
used intensive insulin treatments)

David Spiegel, M.D. (psychiatrist) of Stanford did a follow-up study of a 
breast cancer (profesionaly facilitated) support group that he was involved 
in during the early 80s.  The follow up study showed that the patients in 
the "supportive/expressive" support group lived twice as long as the 
control group that they were compared with.  Both groups had conventional 
treatment and the only identifiable difference for the longer living group 
was the SUPPORT GROUP membership...

What makes it interesting is that they did not exclude people who signed up 
and never attended the group - and still the longevity of the experimental 
group as a whole....


The specific part of the quote about the experimental DCCT group that got 
my attention is:  "...cared for by an experienced team including a nurse, a 
dietitian and a diabetologist, among others. They received intensive 
diabetes education and nutritional instruction, were monitored by telephone 
every week and visited their clinic monthly."

This is an amazing amount of long-term support that few "regular" people 
are able to afford or even find

If the DCCT did not account for the psychological variables in the groups, 
might their "proof" that it is all "BG control" be flawed?



I found the following quote that is a sample chapter from the book:

	Confronting Diabetes
	by Frank Davis, DPM, and Jere Matlock


"The 1441 people in the trial were randomly assigned to two groups, each 
group getting about half of                                  the people. 
The first group of people received "normal", conventional treatment for 
their diabetes. They
used the same regimen followed by the majority of people with Type I 
diabetes--they took one or two                                  insulin 
injections a day, did daily self-monitoring of their blood glucose, and had 
a program of diabetes                                  education that 
included nutritional instruction. They visited their clinic every three 
months.

The second group, however, received a more intensive kind of care. The 
people in that second group                                  were cared for 
by an experienced team including a nurse, a dietitian and a diabetologist, 
among others.                                  They received intensive 
diabetes education and nutritional instruction, were monitored by 
telephone                                  every week and visited their 
clinic monthly. They checked their blood glucose four or more times a 
day                                  and injected insulin three or more 
times a day (or used an insulin pump). They adjusted their 
own                                  insulin dosages. (These people were 
confronting and controlling their diabetes--with a vengeance!)

At the end of ten years of this, you might ask, what was the difference in 
the two groups?

A person in the intensively managed group was 40% to 75% less likely to 
have gotten the                                  complications of diabetic 
retinopathy, neuropathy (nerve disease), and nephropathy (kidney disease).

With regard to their blood glucose levels, the people in the second group 
were able to average 155                                  mg/dL, and 
averaged a glyco hemoglobin level of about 7.2%.

The people in the first, conventional treatment group averaged blood 
glucose levels of 231 mg/dL, and                                  averaged 
a glyco hemoglobin level of 9.0%. (They weren't being pressured to confront 
their diabetes                                  as often or control it as 
well as the second group.) "


Jim S.
email @ redacted
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