Translating “Tight Control”?
Authors: Michael M. Engelgau, Linda S. Geiss, Dara Murphy, K M. Venkat Narayan, Frank Vinicor
Journal: Annals of Internal Medicine (2004)

Letters16 November 2004Translating “Tight Control”?Michael M. Engelgau, MD, Linda S. Geiss, MS, Dara Murphy, MPH, K M. Venkat Narayan, MD, and Frank Vinicor, MDMichael M. Engelgau, MDFrom National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA 30341.Search for more papers by this author, Linda S. Geiss, MSFrom National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA 30341.Search for more papers by this author, Dara Murphy, MPHFrom National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA 30341.Search for more papers by this author, K M. Venkat Narayan, MDFrom National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA 30341.Search for more papers by this author, and Frank Vinicor, MDFrom National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA 30341.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-141-10-200411160-00023 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE:We thank Dr. Finucane for his interest in diabetes translation and his recognition of its importance. He questioned the effectiveness of interventions to improve glycemic control and whether such interventions are ready for translation. We agree that no clinical trial has shown that improved glycemic control prevents single end-stage microvascular complications, such as blindness and kidney disease (1). However, such end-stage events are rare, and researchers would need to conduct decades of follow-up to detect enough cases for meaningful analyses. More often, clinical trials have either examined conditions antecedent to end-stage complications (for example, retinopathy rather than blindness) ...References1. Harris R, Donahue K, Rathore SS, Frame P, Woolf SH, Lohr KN. Screening adults for type 2 diabetes: a review of the evidence for the U.S. Preventive Services Task Force. Ann Intern Med. 2003;138:215-29. [PMID: 12558362] LinkGoogle Scholar2. The effect of intensive treatment of diabetes on the development and progression of long-term complications in insulin-dependent diabetes mellitus. The Diabetes Control and Complications Trial Research Group. N Engl J Med. 1993;329:977-86. [PMID: 8366922] CrossrefMedlineGoogle Scholar3. Intensive blood-glucose control with sulphonylureas or insulin compared with conventional treatment and risk of complications in patients with type 2 diabetes (UKPDS 33). UK Prospective Diabetes Study (UKPDS) Group. Lancet. 1998;352:837-53. [PMID: 9742976] CrossrefMedlineGoogle Scholar4. Klein R. Hyperglycemia and microvascular and macrovascular disease in diabetes. Diabetes Care. 1995;18:258-68. [PMID: 7729308] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA 30341. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoScreening Adults for Type 2 Diabetes: A Review of the Evidence for the U.S. Preventive Services Task Force Russell Harris , Katrina Donahue , Saif S. Rathore , Paul Frame , Steven H. Woolf , and Kathleen N. Lohr Moving Diabetes Care from Science to Practice: The Evolution of the National Diabetes Prevention and Control Program Dara Murphy , Tom Chapel , and Cynthia Clark The Evolving Diabetes Burden in the United States Michael M. Engelgau , Linda S. Geiss , Jinan B. Saaddine , James P. Boyle , Stephanie M. Benjamin , Edward W. Gregg , Edward F. Tierney , Nilka Rios-Burrows , Ali H. Mokdad , Earl S. Ford , Giuseppina Imperatore , and K. M. Venkat Narayan Translating “Tight Control”? Thomas E. Finucane Metrics 16 November 2004Volume 141, Issue 10Page: 822-823KeywordsBlindnessClinical trialsHeart failureProspective studiesQuality of lifeRenal diseasesRenal failureRetinopathyType 1 diabetesType 2 diabetes ePublished: 16 November 2004 Issue Published: 16 November 2004 Copyright & PermissionsCopyright © 2004 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...