How Have Patients Reacted to the Implications of the DCCT?

Abstract

OBJECTIVES To assess the reactions of people with insulin-treated diabetes (ITD) to the results of the Diabetes Control and Complications Trial (DCCT). RESEARCH DESIGN AND METHODS A leaflet documenting the purpose and results of the DCCT was circulated to all 771 patients ages 15–60 years with ITD attending our clinic. Patients were invited to complete and return a questionnaire on their responses. RESULTS Of 550 respondents, 330 felt encouraged to improve glycemic control. Female respondents (P = 0.003) and younger age-groups (15–25 years, P = 0.001) were most likely to want to improve control. Patients with long duration of diabetes (> 20 years, P = 0.00001), hypoglycemia unawareness (P = 0.0001), or previous severe hypoglycemia (P = 0.001) were less likely to want to improve their control. Fear of hypoglycemia concerned all age-groups, whereas female respondents were most likely to be worried about the potential for weight gain (P = 0.00006). CONCLUSIONS Knowledge of the results of the DCCT encourages significant numbers of patients to want to improve glycemic control. Fear of hypoglycemia and, in women, weight gain may prove significant impediments to the clinical implementation of the results of the DCCT.