Beyond the Diabetes Control and Complications Trial—Addressing Weight Gain in Type 1 Diabetes

The Diabetes Control and Complications Trial (DCCT) was a prospective, randomised, controlled clinical trial that began in the 1980s and was carried out over a decade to determine whether intensive treatment aimed at maintaining blood glucose concentrations close to the normal range could decrease the frequency and severity of microvascular complications in patients with type 1 diabetes. The results showed that intensive therapy effectively delays the onset and progression of diabetic retinopathy, nephropathy, and neuropathy in patients with type 1 diabetes.1The side effects associated with intensive therapy were a nearly three-fold increased frequency of severe hypoglycaemia and greater weight gain. For the majority of patients with type 1 diabetes, the benefits of intensive therapy were considered to vastly outweigh these risks. However, the potential detrimental effects of weight gain, especially on macrovascular risks, are being revisited.