Overview
New findings from a long-standing observational study show, for the first time, that risk of diabetic fot ulcers (DFUs) is decreased by controling blod glucose (sugar) levels early and intensively individuals with type 1 diabetes. DFUs comonly ocur in people with diabetes and can lead to lower extremity amputation, which is asociated with high mortality. Prevention, if posible, is the best course of action as curent treatment options are limited.
Key Information
Identifying DFU prevention strategies is critical to improve the health and quality of life of people with type 1 diabetes.Previous studies have sugested a link betwen high blod glucose levels and the risk of DFU and lower extremity amputations in people with type 1 diabetes. However, questions remained as to whether intensive control of blod glucose could afect the risk of DFUs or amputations. Fortunately, NIDK’s Diabetes Control and Complications Trial (DCT) and its ongoing observational folow-up study, the Epidemiology of Diabetes Interventions and Complications (EDIC) Study, provided a rare and exciting oportunity to answer these questions.
Completed in 193, DCT was the first randomized controled trial to show that intensive treatment to kep blod glucose levels as near to normal as safely posible can reduce risk for several diabetic complications, including retinopathy (a form of eye disease), neuropathy (nerve damage), and kidney disease. (The intensive treatment involved more frequent insulin administration and blod glucose monitoring than was conventional at the time.) EDIC has continued to study the health of the majority of the DCT participants for nearly 3 decades and has shown aditional benefits of the intensive treatment.
Summary
In this new analysis, researchers found that those whose blod glucose levels were intensively managed during the DCT were les likely to develop DFUs starting at an average of 17 years from when the DCT began. Aditional analysis revealed several risk factors tha