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Titolo:
Epidemiology of Diabetes Interventions and Complications (EDIC): Design, implementation, and preliminary results of a long-term follow-up of the Diabetes Control and Complications Trial cohort
Autore:
Genuth, S; Nathan, D; Shamoon, H; Duffy, H; Dahms, B; Mayer, L; Brillion, D; Lackaye, M; Whitehouse, F; Kruger, D; Bergenstal, R; Johnson, M; Jacobson, A; Doyle, J; Waters, M; Nathan, D; Crowell, S; Godine, J; McKitrick, C; Service, J; Ziegler, G; Colwell, J; Wood, D; Maytield, R; Molitch, M; Schaefer, B; Kolterman, O; Lorenzi, G; Sivitz, M; Bayless, M; Counts, D; Kowarski, A; Ostrowski, D; Greene, D; Martin, C; Bantle, J; Rogness, B; Goldstein, D; Smith, A; Schade, D; Johannes, C; Schwartz, S; Maschak-Carey, BJ; Orchard, T; Silvers, N; Malone, J; Mangione, A; Kitabchi, A; Murphy, MB; Raskin, P; Strowig, S; Zinman, B; Barnie, A; Palmer, J; Ginsberg, J; Dupre, J; Harth, J; Lorenz, R; Lipps, J; White, N; Santiago, J; Levandoski, L; Tamborlane, W; Gatcomb, P; Dahms, B; Corcoran, P; Quin, J; Lachin, J; Cleary, P; Kenny, D; Diminick, L; Lamas, D; Cowie, C; Eastman, R; Davis, M; Hubbard, L; Geithman, P; Brickbauer, J; Kastorff, L; Neider, M; Steffes, M; Bucksa, J; Chavers, B; OLeary, D; Crow, R; ODonnell, C; Weir, G; Clark, C; DAgostino, R; Espeland, M; Klein, B; Jacobson, H; Manolio, T; Rand, L; Singer, D; Stern, M; Cleary, P; Barnie, A; Genuth, S; Maffin, C; Tamborlane, W; Wesche, J; Nathan, D;
Indirizzi:
Albert Einstein Coll Med, Bronx, NY 10461 USA Albert Einstein Coll Med Bronx NY USA 10461 Coll Med, Bronx, NY 10461 USA Case Western Reserve Univ, Cleveland, OH 44106 USA Case Western Reserve Univ Cleveland OH USA 44106 Cleveland, OH 44106 USA Cornell Univ, Med Ctr, Ithaca, NY 14853 USA Cornell Univ Ithaca NY USA 14853 nell Univ, Med Ctr, Ithaca, NY 14853 USA Henry Ford Hlth Syst, Detroit, MI USA Henry Ford Hlth Syst Detroit MI USA enry Ford Hlth Syst, Detroit, MI USA Int Diabet Ctr, Minneapolis, MN USA Int Diabet Ctr Minneapolis MN USAInt Diabet Ctr, Minneapolis, MN USA Joslin Diabet Ctr, Boston, MA USA Joslin Diabet Ctr Boston MA USAJoslin Diabet Ctr, Boston, MA USA Massachusetts Gen Hosp, Boston, MA 02114 USA Massachusetts Gen Hosp Boston MA USA 02114 Gen Hosp, Boston, MA 02114 USA Mayo Clin & Mayo Fdn, Rochester, MN USA Mayo Clin & Mayo Fdn Rochester MNUSA Clin & Mayo Fdn, Rochester, MN USA Med Univ S Carolina, Charleston, SC USA Med Univ S Carolina Charleston SCUSA niv S Carolina, Charleston, SC USA Northwestern Univ, Evanston, IL 60208 USA Northwestern Univ Evanston IL USA 60208 tern Univ, Evanston, IL 60208 USA Univ Calif San Diego, San Diego, CA 92103 USA Univ Calif San Diego San Diego CA USA 92103 iego, San Diego, CA 92103 USA Univ Iowa, Iowa City, IA 52242 USA Univ Iowa Iowa City IA USA 52242Univ Iowa, Iowa City, IA 52242 USA Univ Maryland, Sch Med, College Pk, MD 20742 USA Univ Maryland College PkMD USA 20742 , Sch Med, College Pk, MD 20742 USA Univ Michigan, Ann Arbor, MI 48109 USA Univ Michigan Ann Arbor MI USA 48109 iv Michigan, Ann Arbor, MI 48109 USA Univ Minnesota, Minneapolis, MN 55455 USA Univ Minnesota Minneapolis MN USA 55455 nesota, Minneapolis, MN 55455 USA Univ Missouri, Columbia, MO 65211 USA Univ Missouri Columbia MO USA 65211Univ Missouri, Columbia, MO 65211 USA Univ New Mexico, Albuquerque, NM 87131 USA Univ New Mexico Albuquerque NMUSA 87131 exico, Albuquerque, NM 87131 USA Univ Penn, Philadelphia, PA 19104 USA Univ Penn Philadelphia PA USA 19104Univ Penn, Philadelphia, PA 19104 USA Univ Pittsburgh, Pittsburgh, PA 15260 USA Univ Pittsburgh Pittsburgh PA USA 15260 tsburgh, Pittsburgh, PA 15260 USA Univ S Florida, Tampa, FL 33620 USA Univ S Florida Tampa FL USA 33620Univ S Florida, Tampa, FL 33620 USA Univ Tennessee, Knoxville, TN 37996 USA Univ Tennessee Knoxville TN USA 37996 Tennessee, Knoxville, TN 37996 USA Univ Texas, SW Univ Med Ctr, Houston, TX USA Univ Texas Houston TX USAUniv Texas, SW Univ Med Ctr, Houston, TX USA Univ Toronto, Toronto, ON, Canada Univ Toronto Toronto ON CanadaUniv Toronto, Toronto, ON, Canada Univ Washington, Seattle, WA 98195 USA Univ Washington Seattle WA USA 98195 iv Washington, Seattle, WA 98195 USA Univ Western Ontario, London, ON N6A 3K7, Canada Univ Western Ontario London ON Canada N6A 3K7 London, ON N6A 3K7, Canada Vanderbilt Univ, Nashville, TN USA Vanderbilt Univ Nashville TN USAVanderbilt Univ, Nashville, TN USA Washington Univ, St Louis, MO 63130 USA Washington Univ St Louis MO USA 63130 ington Univ, St Louis, MO 63130 USA Yale Univ, Sch Med, New Haven, CT 06520 USA Yale Univ New Haven CT USA 06520 e Univ, Sch Med, New Haven, CT 06520 USA George Washington Univ, Ctr Biostat, Washington, DC 20052 USA George Washington Univ Washington DC USA 20052 , Washington, DC 20052 USA NIDDKD, Program Off, Bethesda, MD USA NIDDKD Bethesda MD USANIDDKD, Program Off, Bethesda, MD USA Univ Wisconsin, Madison, WI 53706 USA Univ Wisconsin Madison WI USA 53706Univ Wisconsin, Madison, WI 53706 USA New England Med Ctr, Boston, MA USA New England Med Ctr Boston MA USANew England Med Ctr, Boston, MA USA
Titolo Testata:
DIABETES CARE
fascicolo: 1, volume: 22, anno: 1999,
pagine: 99 - 111
SICI:
0149-5992(199901)22:1<99:EODIAC>2.0.ZU;2-W
Fonte:
ISI
Lingua:
ENG
Soggetto:
CORONARY-ARTERY DISEASE; LONGITUDINAL DATA; JUVENILE-ONSET; RISK-FACTORS; RETINOPATHY; IDDM; NEPHROPATHY; PROGRESSION; NEUROPATHY; PREDICTION;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
50
Recensione:
Indirizzi per estratti:
Indirizzo: Genuth, S EDIC Res Grp, Box NDIC-DCCT, Bethesda, MD 20892 USA EDIC Res GrpBox NDIC-DCCT Bethesda MD USA 20892 a, MD 20892 USA
Citazione:
S. Genuth et al., "Epidemiology of Diabetes Interventions and Complications (EDIC): Design, implementation, and preliminary results of a long-term follow-up of the Diabetes Control and Complications Trial cohort", DIABET CARE, 22(1), 1999, pp. 99-111

Abstract

OBJECTIVE - The Diabetes Control and Complications Trial (DCCT) demonstrated the powerful impact of glycemic control on the early manifestations of microvascular complications. Contemporary prospective data on the evolution of macrovascular and late microvascular complications of type 1 diabetes are limited. The Epidemiology of Diabetes Interventions and Complications (EDIC) study is a multicenter, longitudinal, observational study designed to use the well-characterized DCCT cohort of >1,400 patients to determine the long-term effects of prior separation of glycemic levels on micro- and macrovascular outcomes. RESEARCH DESIGN AND METHODS - Using a standardized annual history and physical examination, 28 EDIC clinical centers that were DCCT clinics will follow the EDIC cohort for 10 years. Annual evaluation also includes resting electrocardiogram, Doppler ultrasound measurements of ankle/arm blood pressure, and screening for nephropathy At regular intervals, a timed 4-h urine iscollected, lipid profiles are obtained, and stereoscopic fundus photographs are taken. In addition, dual B-mode Doppler ultrasound scans of the common and internal carotid arteries will be performed at years 1 and 6 and at study end. RESULTS - Written informed consent was obtained from 96% of the DCCT subjects. The participants, compared with nonparticipants, tended to have betterglycemic control at the completion of the DCCT and were more likely to have their diabetes care provided by DCCT personnel. The EDIC baseline measurement stratified by sex delineates multiple cardiovascular disease risk factor differences such as age (older in men), waist-to-hip ratio (higher in men), HDL cholesterol (lower in men), hypertension (more prevalent in men), and maximum intimal-medial thickness of common and internal carotid arteries(thicker in men). Of the original conventional treatment group, 69% have changed to continuous subcutaneous insulin infusion or multiple daily injections. Although the mean HbA(1c) difference between the intensive and conventional treatment groups narrowed at EDIC years 1 and 2, HbA(1c) remained significantly lower in the intensive group. Of all expected clinic visits, 95% were completed, and the quality of EDIC data is very similar to that observed in the DCCT. CONCLUSIONS - Although obvious problems exist in extended follow-up studies of completed clinical trials, these are balanced by the value of continued systematic observation of the DCCT cohort. In contrast to other epidemiologic studies, EDIC will provide 1) definitive data on type 1 as distinct from type 2 diabetes; 2) reliance on prospective rather than on cross-sectional analysis; 3) long-term followup in a large population; 4) consistent useof objective, reliable measures of outcomes and glycemia; and 5) observation of patients from before the onset of complications.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 07/07/20 alle ore 15:18:21