Major improvements in glucose monitoring and insulin delivery introduced in the past decade are now helping patients control their blood glucose more precisely and conveniently and reduce the risk of hypoglycemia. For example, several continuous glucose monitoring devices approved by the Food and Drug Administration give both trend and real-time information on glucose levels. Insulin pump technology is also improving, and researchers have begun testing a system that combines both technologies in patients with newly diagnosed type 1 diabetes.

In the United States, nearly 24 million people have diabetes. In adults, type 1 diabetes accounts for 5 to 10 percent of all diagnosed cases of diabetes. Formerly called juvenile-onset diabetes or insulin-dependent diabetes, type 1 diabetes develops when the body's immune system destroys pancreatic beta cells, the only cells in the body that make the hormone insulin that regulates blood glucose. This form of diabetes usually arises in children and young adults, but it can occur at any age. Management involves keeping blood glucose levels as close to normal as possible with three or more insulin injections a day or treatment with an insulin pump, careful monitoring of glucose, and close attention to diet and exercise.

Type 2 diabetes, or adult-onset diabetes, accounts for about 90 to 95 percent of all diagnosed cases of diabetes in adults. It usually begins as insulin resistance, a disorder in which the cells do not use insulin properly. As the need for insulin rises, the pancreas gradually loses its ability to produce it. Type 2 diabetes is associated with older age, obesity, family history of diabetes, history of gestational diabetes, impaired glucose metabolism, physical inactivity, and race/ethnicity. African Americans, Hispanic/Latino Americans, American Indians, and some Asian Americans and Native Hawaiians or other Pacific Islanders are at particularly high risk for type 2 diabetes and its complications.

The DCCT is registered as NCT00360815, and EDIC is registered as NCT00360893 in clinicaltrials. The DCCT/EDIC is funded by the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), the National Eye Institute, the National Institute of Neurological Disorders and Stroke, and the General Clinical Research Centers Program, National Center for Research Resources, within the NIH. Genentech contributed to the DCCT/EDIC through a Cooperative Research and Development Agreement with the NIDDK. Lifescan, Roche, Aventis, Eli Lilly, Omnipod, Can-Am, B-D, Animas, Medtronic, Medtronic Minimed, Bayer, and Omron, contributed free or discounted supplies to the DCCT/EDIC. The EDC study is funded by the NIDDK.

NIDDK, part of the NIH, conducts and supports basic and clinical research and research training on some of the most common, severe and disabling conditions affecting Americans. The Institute's research interests include diabetes and other endocrine and metabolic diseases; digestive diseases, nutrition, and obesity; and kidney, urologic and hematologic diseases.

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