:

The Diabetes Control and Complications Trial Research Group (DCCT)

N Engl J Med 329: 977-986, 1993

Glycemic Control (Lower HbA1c) and

Incidence of Complications
DCCT1*

Kumamoto2

UKPDS3

HbA1c

~9% vs ~7%

9.4% vs 7.1%

7.9% vs 7.0%

Retinopathy

63%

69%

21%

Nephropathy

39% to 54%

70%

34%

Neuropathy

60%

Macrovascular
disease

41%

16%

*Conducted in type 1 diabetes. Conducted in type 2 diabetes.

Values on slide are not statistically significant.
1. The Diabetes Control and Complications Trial Research Group. N Engl J Med. 1993;329:977-986.
2. Ohkubo et al. Diabetes Res Clin Pract. 1995;28:103-117. 3. UK Prospective Diabetes Study
Group (UKPDS). Lancet.1998;352:837-853.

Incidence of diabetes-related
complications (%)

UKPDS: increased risk of diabetesdiabetes-related complications

corresponding with a 1% increase in HbA1c

50
40

+37%

30
+21%
20
+14%

+12%

10
0

Increase in any
diabetes-related
endpoint

Increase in risk
of myocardial
infarction

Increase in risk
of stroke

Increase in risk
of microvascular
complications

Adapted from Stratton IM, et al. UKPDS 35. BMJ 2000; 321:405412.

HbA1c < 7%

(.. 4 -6%)

()

: 70 130 mg/d
: < 180 mg/dl

American Diabetes Association

Clinical Practice Recommendations 2011


HbA1c

HbA1c

American Diabetes Association

Clinical Practice Recommendations 2011


4
3,5
3
2,5

1,5
1
0,5
0
76

84

91

98

123

136

148

162

105

175



MRFIT
250
225
200
175
150
125
100
75
50
25
0

(n=342.815)
(n=5.163)

<120 120-139 140-159 160-179 180-199 200

= =(mmHg)
RFIT=

Stamler J, et al. Diabetes Care. 1993;16:434-444.