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. 2006 Feb;29(2):340-4.
doi: 10.2337/diacare.29.02.06.dc05-1549.

Neuropathy among the diabetes control and complications trial cohort 8 years after trial completion

Catherine L Martin  1 , James Albers, William H Herman, Patricia Cleary, Barbara Waberski, Douglas A Greene, Martin J Stevens, Eva L Feldman; DCCT/EDIC Research Group
Affiliations

Neuropathy among the diabetes control and complications trial cohort 8 years after trial completion

Catherine L Martin et al. Diabetes Care. 2006 Feb.

Abstract

Objective: To evaluate the impact of prior intensive diabetes therapy on neuropathy among former Diabetes Control and Complications Trial (DCCT) participants.

Research design and methods: At the conclusion of the DCCT, subjects in the intensive group were encouraged to maintain intensive therapy, and subjects in the conventional group were encouraged to begin intensive therapy. Thereafter, we annually assessed neuropathy as part of the Epidemiology of Diabetes Intervention and Complications (EDIC) study. Neuropathy was defined using the Michigan Neuropathy Screening Instrument (MNSI). We recorded potential adverse consequences of neuropathy.

Results: At the first EDIC examination, 1,257 subjects participated in the neuropathy assessment. Consistent with DCCT results, the former intensive group showed a lower prevalence of neuropathy than the conventional group based on positive questionnaire (1.8 vs. 4.7%; P = 0.003) or examination (17.8 vs. 28.0%; P < 0.0001) results. Despite similar levels of glycemic control, symptoms and signs of neuropathy remained less prevalent among the former intensive group compared with the conventional group. At the beginning of the EDIC study, prior intensive therapy reduced the odds of having symptoms and signs of neuropathy using MNSI criteria by 64% (P = 0.0044) and 45% (P < 0.0001), respectively, with similar odds reductions observed for both neuropathic symptoms (51%, P < 0.0001) and neuropathic signs (43%, P < 0.0001) across 8 years of EDIC follow-up.

Conclusions: The benefits of 6.5 years of intensive therapy on neuropathy status extended for at least 8 years beyond the end of the DCCT, similar to the findings described for diabetic retinopathy and nephropathy.

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Figures

Figure 1
Figure 1
Frequency of neuropathy-positive MNSI questionnaires across 8 years of the EDIC study among former DCCT conventional therapy (●) and intensive therapy (◻) subjects without confirmed clinical neuropathy at the end of the DCCT. P < 0.0001 on average for all EDIC years combined.
Figure 2
Figure 2
Frequency of neuropathy-positive MNSI examinations across 8 years of the EDIC study among former DCCT conventional therapy (●) and intensive therapy (◻) subjects without confirmed clinical neuropathy at the end of the DCCT. P < 0.0001 on average for all EDIC years combined.
See this image and copyright information in PMC

References

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