Implications of the DCCT: Looking beyond tight control

The main conclusion of the recently completed, landmark Diabetes Control and Complications Trial (DCCT), i. e., the fact that tight control significantly reduces the risk of diabetes-related complications, has been widely acclaimed. This enthusiasm has been fueled in part by the magnitude of the advantage tight control seems to offer: the 2% difference in average HbA_1c between the DCCT standard and intensive treatment groups was associated with a 60% reduction in risk for diabetic reti-nopathy, nephropathy, and neuropathy.