Implications
The authors of the study featured the benefits of close control — clearly reduced eye, kidney, and nerve damage — in their conclusion. This supports the clinical value of tighter control afforded by multiple daily injections (MDI) or continuous subcutaneous insulin infusion combined with lower blood glucose targets and lower HbA1C goals. Prior to the DCCT, there simply was no medical proof that the additional burden of intensive insulin therapy over the convenience of fewer shot per day with conventional insulinotherapy was worth the tradeoff.
In hindsight, this conclusion now seems obvious. However, to the diabetic adult patient who resists the additional burden and/or expense of tighter control, the DCCT provides medical evidence that tighter control is measurably favorable to the patient.
The DCCT provided quantifiable justification to healthcare providers that the additional expenses associated with intensive glycemic control and close monitoring of diabetes are cost effective. The medical costs of managing the complications of poorly-treated diabetes and the welfare costs of blind or amputated diabetic adults, or who die or are incapacitated whilst still of a working (economically active) age are significantly greater than any savings that might be made by withholding primary care.
Despite the fact that the DCCT studied only a restricted group of people with type 1 diabetes, many clinicians began recommending tight control to both people with type 1 and type 2 diabetes. Additionally, many medical centers started using a team approach to treating diabetics, consisting of a physician, nurse educator, dietitian, and behavioral therapist, although the practice remains limited because of the manner in which healthcare is actually delivered and paid for in many places.
Read more about this topic: Diabetes Control And Complications Trial
Famous quotes containing the word implications:
“When it had long since outgrown his purely medical implications and become a world movement which penetrated into every field of science and every domain of the intellect: literature, the history of art, religion and prehistory; mythology, folklore, pedagogy, and what not.”
—Thomas Mann (1875–1955)
“Philosophical questions are not by their nature insoluble. They are, indeed, radically different from scientific questions, because they concern the implications and other interrelations of ideas, not the order of physical events; their answers are interpretations instead of factual reports, and their function is to increase not our knowledge of nature, but our understanding of what we know.”
—Susanne K. Langer (1895–1985)
“The power to guess the unseen from the seen, to trace the implications of things, to judge the whole piece by the pattern, the condition of feeling life in general so completely that you are well on your way to knowing any particular corner of it—this cluster of gifts may almost be said to constitute experience.”
—Henry James (1843–1916)