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From Connecticut, USA:

I have just completed a chart review for our local diabetes treatment program for children. I would like to compare the HbA1c outcomes for our Connecticut children with the levels documented in the "intensive treatment" and "conventional treatment" groups for the adolescents studied in the DCCT. I have not seen an article that contains the demographic or outcome information for just the children in the DCCT study. Can you point me in the right direction?


This question was referred to a pediatric endocrinologist colleague, who has been involved in the DCCT:

The DCCT Research Group authored a peds-only DCCT report in the Journal of Pediatrics.

Also please be aware of differences in A1c and GHB assays when you analyze the data since they are quite considerable. You should be aware of the Hdivore multinational study coordinated by Henrik Mortensen at the Glostrup Hospital outside of Copenhagen, since his technology and statistical assessments may be helpful with your own work. Henrik's study was reported at the Pittsburgh ISPAD meetings in June 1996 and are in abstract form in Journal of Pediatric Endocrinology and Metabolism.


Additional Comment by Dr. Lebinger:

The results of the DCCT study of adolescents were analyzed and reported separately in the Journal of Pediatrics, Volume 125, pages 177 - 188, August 1994. There were 195 adolescents between the ages of 13 - 17 at entry into the trial who were followed for an average of 7.4 years (some of them past adolescence.) The mean HgbA1c for the "intensively" treated adolescents was 8.06% vs 9.76% in the "conventionally" treated group. The "non-diabetic range for HgbA1C in the method used in the DCCT study was < 6.05% (other labs may have different non-diabetic ranges, so it is difficult to compare HgbA1C's done by different methods in different labs).

The corresponding HgbA1C's for the adult group was 7.12% for the "intensively" treated group and 9.02% for the "conventionally" treated group.

Other interesting statistics in the adolescent report: (Conventional vs. Intensive)

Severe low blood sugar requiring assistance: 45% vs 82%
27.8 events per 100 patient years
vs. 85.7 events per 100 patient years
Severe low blood sugar resulting in coma or seizure: 25% vs. 63%
9.7 events per 100 patient years
vs. 26.7 events per 100 patients years.
Becoming "overweight": 29% vs. 48%
4.7 events per 100 patient years
vs. 9.6 events per 100 patient years.
Ketoacidosis: 20% vs. 18%
4.7 events per 100 patient years
vs. 2.8 events per 100 patient years.
Any sustained retinopathy
absolute rate per 100 patient years:
23 vs. 18
(Adolescents with no retinopathy at beginning of study)
Greater than 3 step progression in retinopathy
absolute rate per 100 patient years
6.3 vs 3.2
(Adolescents with no retinopathy at beginning of study)

7.4 vs 2.9
(Adolescents with early retinopathy at beginning of study)

absolute rate per 100 patient years:
7.1 vs 5.8
(Adolescents with no retinopathy at beginning of study)

12.7 vs 6.6
(Adolescents with retinopathy at beginning of study)

Please note retinopathy and nephropathy was not defined as blindness or kidney failure, but any change in kidney tests or in the eye, whether or not clinically significant. No one went blind or developed kidney failure during the time of the study though a few individuals did require laser treatment of the eyes.


Original posting 4 Apr 97


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Last Updated: Tuesday April 06, 2010 15:08:54
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