ABSTRACT
Since the initial findings from the Diabetes Control and Complications Trial (DCCT) were published in 1993 (1), the intensification of diabetes management to prevent or slow the onset of the complications associated with type 1 diabetes (T1D) has been a hallmark of diabetes treatment. The DCCT findings confirmed the strong link between hyperglycemia and the complications and put to rest a debate about the necessity of tight glycemic control [see (2) and (3) for the history of this debate]. During the past two decades, much attention has been paid to the mechanisms that promote hyperglycemia-induced tissue damage and to the potential ways to modify this process (4-6). The targeted population for intensified diabetes management may well be 2 million adults with T1D in the United States-based on the estimate of 10% of the 20.6 million diabetes patients (7). Further, the incidence of T1D appears to be increasing with a tendency toward younger age at onset (8-10). Taken together, there is a large population of individuals at risk for complications due to T1D with the likelihood of growing numbers in the future.
