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José Barbosa, MD; Michael W. Steffes, MD, PhD; S. Michael Mauer, MD
University of Minnesota Minneapolis

JAMA. 1995;273(10):773.

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

In Reply.

—Dr Poothullil questions the evidence supporting glycemia as a risk factor for diabetic complications. Furthermore, he asks whether other measures (such as lipid levels) correlated more closely with the prevention of the structure manifestations of diabetic nephropathy. Unfortunately, in bolstering his claim for a "lack of correlation between a persistent hyperglycemic state and the development of diabetic nephropathy," he has chosen a reference nearly two decades old (his reference 4) that relates to non—insulin-independent diabetes mellitus. In addition to our work showing a strong relationship between glycemic control and the early lesions of diabetic nephropathy in humans,¹ the Diabetes Control and Complications Trial (DCCT)² and other studies^3-5 have demonstrated a strong correlation between improved glycemic control and the prevention or reversal of the complications of diabetes. The DCCT demonstrated that lipid levels did not relate as well to the development of complications as did the . . . [Full Text PDF of this Article]

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