EPIDEMIOLOGY OF DIABETES INTERVENTIONS AND COMPLICATIONS (EDIC)

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This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. In January 2006, the DCCT/EDIC entered the 10-year extension of the follow-up of the cohort. The Core protocol is the same as the basic protocol followed for the first 12 years of EDIC. The Diabetes Control and Complications Trial (DCCT) and the Epidemiology of Diabetes Interventions and Complications (EDIC) follow-up study have established the short-term and longer-term impact of intensive diabetes therapy on retinopathy, nephropathy, neuropathy, and cardiovascular disease (CVD). In addition, they have defined the roles of hyperglycemia and other risk factors on the development and progression of complications. The previous results of DCCT/EDIC have been seminal in developing the modern-day therapy of Type 1 diabetes that has been adopted worldwide. The DCCT/EDIC cohort has been followed with consistent, validated methods for a mean of 16 (13-20) years with 94% retention and represents the most carefully studied group of Type 1 diabetic patients in history. The current protocol describes further follow-up of the DCCT/EDIC cohort with the goals of: determining the very long-term effects of the original interventions on advanced complications; exploring the longevity of the imprinting ("metabolic memory") phenomenon; delineating the modern-day clinical course of diabetic complications including the interactions among complications and co-occurrence of complications; examining the long (er)-term effects of intensive vs. conventional therapy on cardiovascular events; exploring the pathophysiologic mechanisms that underlie the development and progression of microvascular, neurologic, and cardiovascular complications; and defining the long-term quality of life and economic impacts of intensive therapy.