Comments on: The Dirty Truth Behind DCCT http://challengediabetes.diabetech.net/2009/08/16/the-dirty-truth-behind-dcct/ Thoughts about current approaches to managing diabetes Tue, 07 Sep 2010 17:14:23 +0000 http://wordpress.org/?v=2.6.1 By: Arnett http://challengediabetes.diabetech.net/2009/08/16/the-dirty-truth-behind-dcct/#comment-53160 Arnett Fri, 12 Mar 2010 05:58:38 +0000 http://challengediabetes.diabetech.net/?p=1006#comment-53160 I am a medical laboratory technologist from Canada. Do you think that if nealth reform goes through, it will help patients get better diabetic control. Also, what did you think of the NICE-SUGAR study on Intensive Vs, conventional glucose control in critically ill patients? I think the joint statement from the ADA and the AACE (http://www.newswise.com/articles/view/550381) was well worded. Regards, Mark Hawkins, MLT; I am a medical laboratory technologist from Canada. Do you think that if nealth reform goes through, it will help patients get better diabetic control. Also, what did you think of the NICE-SUGAR study on Intensive Vs, conventional glucose control in critically ill patients? I think the joint statement from the ADA and the AACE (http://www.newswise.com/articles/view/550381) was well worded.
Regards,
Mark Hawkins, MLT;

]]> By: Scott http://challengediabetes.diabetech.net/2009/08/16/the-dirty-truth-behind-dcct/#comment-45505 Scott Wed, 09 Dec 2009 19:56:56 +0000 http://challengediabetes.diabetech.net/?p=1006#comment-45505 The DCCT had a number of "dirty little secrets", some of which you've noted. The DCCT is generally believed to have tracked 1,441 randomly selected diabetic participants for a period of 10 years. The truth is that the study began in 1983 with only 278 participants, the first 2 years were devoted to planning and feasibility studies and the DCCT’s full cohort of 1,441 participants was not achieved until 1989, only 4 years before the study ended. Of the original 278 participants, 8 (2.8%) dropped out and 11 (3.9%) died. These sad statistics were caused in large part by severe hypoglycemia. Changes were subsequently made in the eligibility criteria for the full-scale trial to exclude anyone who experienced severe (meaning required assistance from another person for recovery) hypoglycemia during the preceding 12 months. Talk about cherry-picking: the medical journals indicate that the average patient with type 1 diabetes will experience at least 1 incidence of severe hypoglycemia each year. This particular exclusion raises serious questions about the randomness of this selection process. The reality is that the objective of normalizing glycemic control is a lofty theory that does not translate very well into the reality of today's U.S. healthcare system. One has to ask, then, why research dollars are overwhelmingly stacked towards glycemic control rather than disease eradication (meaning cure technologies)? The DCCT had a number of “dirty little secrets”, some of which you’ve noted. The DCCT is generally believed to have tracked 1,441 randomly selected diabetic participants for a period of 10 years. The truth is that the study began in 1983 with only 278 participants, the first 2 years were devoted to planning and feasibility studies and the DCCT’s full cohort of 1,441 participants was not achieved until 1989, only 4 years before the study ended.

Of the original 278 participants, 8 (2.8%) dropped out and 11 (3.9%) died. These sad statistics were caused in large part by severe hypoglycemia. Changes were subsequently made in the eligibility criteria for the full-scale trial to exclude anyone who experienced severe (meaning required assistance from another person for recovery) hypoglycemia during the preceding 12 months. Talk about cherry-picking: the medical journals indicate that the average patient with type 1 diabetes will experience at least 1 incidence of severe hypoglycemia each year. This particular exclusion raises serious questions about the randomness of this selection process.

The reality is that the objective of normalizing glycemic control is a lofty theory that does not translate very well into the reality of today’s U.S. healthcare system. One has to ask, then, why research dollars are overwhelmingly stacked towards glycemic control rather than disease eradication (meaning cure technologies)?

]]> By: Mark Hawkins http://challengediabetes.diabetech.net/2009/08/16/the-dirty-truth-behind-dcct/#comment-44002 Mark Hawkins Thu, 19 Nov 2009 15:06:39 +0000 http://challengediabetes.diabetech.net/?p=1006#comment-44002 I am a medical laboratory technologist from Canada. Do you think that if health reform goes through, it will help patients get better diabetic control. Also, what did you think of the NICE-SUGAR study on Intensive Vs, conventional glucose control in critically ill patients? I think the joint statement from the ADA and the AACE (http://www.newswise.com/articles/view/550381) was well worded. Regards, Mark Hawkins, MLT I am a medical laboratory technologist from Canada. Do you think that if health reform goes through, it will help patients get better diabetic control.
Also, what did you think of the NICE-SUGAR study on Intensive Vs, conventional glucose control in critically ill patients? I think the joint statement from the ADA and the AACE (http://www.newswise.com/articles/view/550381) was well worded.
Regards,
Mark Hawkins, MLT

]]> By: Rhonda Lanclos http://challengediabetes.diabetech.net/2009/08/16/the-dirty-truth-behind-dcct/#comment-37808 Rhonda Lanclos Fri, 28 Aug 2009 20:21:52 +0000 http://challengediabetes.diabetech.net/?p=1006#comment-37808 Dr. Ponder, Enjoy the blogs. I am looking to future insurance issues, or current issues with the healthcare debate? Any thoughts? Dr. Ponder,
Enjoy the blogs. I am looking to future insurance issues, or current issues with the healthcare debate? Any thoughts?

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