The diabetes control and complications trial. Implications for policy and practice.

The results of the Diabetes Control and Complications Trial (DCCT), published in this issue of the Journal,1 demonstrate that intensive insulin therapy can delay the onset and slow the progression of retinopathy, nephropathy, and neuropathy in patients with insulin-dependent diabetes mellitus (IDDM). These findings, which extend those of two other recent studies,2,3 should put to rest the longstanding debate over whether attempts to improve glycemic control beyond that required to control the symptoms of diabetes are worthwhile. But the DCCT raises a new and equally challenging set of questions. The study was limited to a small subgroup of people . . .