Jim Telfer has been living with diabetes since he was 12 years old – and knows all too well the complex nature of the chronic disease and the serious health complications it causes.
So, when he saw an opportunity to participate in a clinical trial, it was an easy decision.
“I really wanted to be a part of that, to be helpful for the future,” says Telfer, a London, Ont.-based design artist.
Telfer is a patient at St. Joseph’s Health Care London’s Centre for Diabetes, Endocrinology and Metabolism. It is the primary regional centre for diabetes and endocrine disease management in Southwestern Ontario, bringing together comprehensive diabetes education, leading-edge care and research, and an expert team of care providers and researchers.
The Diabetes Control and Complications Trial (DCCT) – an international landmark research study that began in 1983 – had set out to explore how controlling blood glucose levels of people with Type-1 diabetes can affect their health and alter the progression of the disease and its long-term complications.
London was one of the two Canadian sites to participate in this long-term, international trial that has changed the way diabetes is managed globally.
More than 1,441 patients participated in the decade-long study. Participants were randomized into two different groups. One group received a more intensive treatment of three or more insulin injections per day or an insulin pump with blood glucose monitor. The second group received the standard treatment of one or two injections of insulin per day with self-monitoring of urine or blood glucose.
The ground-breaking results, published in 1993, showed that keeping blood glucose levels close to normal greatly decreased diabetes patients’ chances of developing eye, kidney and nerve disease. The results were published in the New England Journal of Medicine, and soon after physicians around the world began treating diabetes differently.
While the results of the trials provided significant advancements in diabetes care, the research did not end there.
As the DCCT concluded, study participants were invited to engage with a new multicentre, longitudinal observational study called Epidemiology of Diabetes Interventions and Complications (EDIC). As a follow-up study to DCCT, EDIC was designed to test the durability of the DCCT effects on the more-advanced stages of diabetes complications, including cardiovascular disease.
This study continues today and participants meet with researchers annually. They undergo various long-term health assessments, including blood work, cognitive testing, cardiac magnetic resonance imaging, and retinal imaging.
Dr. Charlotte McDonald, an endocrinologist and one of the principal investigators for the EDIC study, says that with 24 study sites across North America, including London, Ontario, and around 1,400 participants, the study will yield a large amount of data that will allow clinicians to better understand the complications of diabetes and the long-term impacts of its treatment.
“We still have participants involved in the EDIC study that started over 28 years ago, making this one of the longest follow-up studies of diabetes patients ever,” says Marsha Driscoll, Research Coordinator at Lawson Health Research Institute, the research arm of London’s hospitals. “Around 90 per cent of those patients are still actively followed which is remarkable for a study of this duration.”