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Still Worthwhile and Worth Pursuing

Steven E. Kahn, MB, ChB

JAMA. 2009;301(15):1590-1592.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

Watershed years and events abound in medicine, and diabetes has been central to many of these defining moments. The identification of insulin in 1922 immediately made it possible to reduce the morbidity and mortality associated with the acute complications of hyperglycemia. However, proving the benefit of better glucose control on chronic microvascular and macrovascular complications has been more difficult.

Demonstration of the benefit of improved glycemic control on the microvascular target organs—the eyes, kidneys, and nerves—was presented in 2 large studies reported in the 1990s. In 1993, the Diabetes Control and Complications Trial (DCCT) provided evidence in a large cohort of patients with type 1 diabetes that intensive glucose control led to an approximate 60% reduction in the risk of disease progression in these organs.¹ In 1998, the United Kingdom Prospective Diabetes Study (UKPDS) showed that 10 years of improved glucose control in . . . [Full Text of this Article]

Glucose Control and Cardiovascular Disease

Author Affiliations: Division of Metabolism, Endocrinology and Nutrition, Department of Medicine, VA Puget Sound Health Care System; and University of Washington, Seattle.

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