MAJOR DECREMENTS IN GLYCATED HEMOGLOBIN LEVELS BETWEEN 1978 AND 1989 IN PATIENTS WITH INSULIN-DEPENDENT DIABETES-MELLITUS

The Diabetes Control and Complications Trial has shown that intensive treatment can deter the development and progression of diabetic compli cations. Integral to intensive treatment is improved glycemic control. To describe the trend in glycemic control for subjects with insulin-d ependent diabetes mellitus, we examined the medical records of 662 sub jects seen between 1978 and 1989 at the Model Demonstration Unit of th e Diabetes Research and Training Center (Washington University School of Medicine). Mean value of glycated hemoglobin showed steady decline from a peak of 11.5% in 1979 to 9.0% in 1989. This decline was observe d both in subjects evaluated only once (annual rate of decline estimat ed from linear regression, -0.17 +/- 0.03; p = 0.0001) and in subjects evaluated more than once (annual rate of decline estimated from growt h curves, -0.18 +/- 0.06; p = 0.0001). These results suggest that subs tantial lowering of glycated hemoglobin has occurred during the last d ecade. This reduction should result in a lowered risk of diabetic comp lications.