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Ann Intern Med. 1996 Feb 15;124(4):379-88.

Effects of intensive diabetes therapy on neuropsychological function in adults in the Diabetes Control and Complications Trial.

[No authors listed]

Abstract

OBJECTIVE:

To examine the effect of intensive therapy on neuropsychological performance in patients who participated in the Diabetes Control and Complications Trial (DCCT).

DESIGN:

Multicenter, randomized, controlled clinical trial.

SETTING:

29 DCCT clinical centers.

PATIENTS:

1441 patients with insulin-dependent diabetes mellitus (IDDM) between 13 and 39 years of age who had had IDDM for 1 to 15 years and had no or minimal retinopathy or nephropathy at baseline. Volunteers were excluded if they had a history of substance abuse, psychological disturbance, or recurrent hypoglycemia with coma or seizure.

INTERVENTION:

Intensive therapy with 3 or more daily insulin injections or continuous subcutaneous insulin infusion, guided by 4 or more glucose tests per day, compared with conventional therapy with 1 or 2 daily insulin injections.

OUTCOME MEASURES:

Neuropsychological assessments were done at baseline; years 2, 5, and 7; and the end of the study. Eight cognitive domain scores were developed from the test results and were used to identify patients whose neuropsychological performance had clinically worsened.

RESULTS:

Intensive therapy did not affect neuropsychological performance. In addition, patients who had repeated episodes of hypoglycemia did not perform differently than patients who did not have repeated episodes.

CONCLUSION:

Intensive therapy and the attendant risk for hypoglycemia were not associated with neuropsychological impairment in the DCCT.

Comment in

  • ACP J Club. 1996 May-Jun;124(3):69.
PMID:
8554246
[Indexed for MEDLINE]

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