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[IP] Might the DCCT have been flawed?
- Subject: [IP] Might the DCCT have been flawed?
- From: email @ redacted
- Date: Thu, 17 May 2001 09:24:03 -0700
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:
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
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.) "
email @ redacted
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