The DCCT from the inside. (Diabetes Control and Complications Trial)(includes related articles on complications of diabetes)

Ken McDonald believes that intensive therapy is so important to his health that he's turned into a medical consumerwarrior battling his health maintenance organization to pay for his vital test strips. Pam Miller believes that hypoglycemia--an issue in intensive therapy--caused her to black out and crash her car into a tree. And D.J. Minor, who wears a pump and performs multiple blood tests, has learned to compensate for occasional variations in his diet--allowing him to have his first taste of pie in eight years.

McDonald, Miller, and Minor are just three of the 1,441 participants in the mammoth Diabetes Control and Complications Trial (DCCT), which concluded a 10-year run in the summer of 1993. It was the largest diabetes study in history, costing at least $165 million, and involving 29 research centers around the nation that enrolled people aged 13 to 39. The money spent on the study ensured that participants received frequent consultations with their medical team and the supplies needed to monitor and treat their diabetes.

The people with Type I diabetes who participated in the study belonged to one of two groups: Experimental or control. The people in the experimental group followed an intensive regimen of monitoring their blood glucose levels four to eight times a day and administering three or more injuections of insulin each day. (Some in the intensive regimen used a pump to administer insulin, but they, too, checked their blood glucose levels four to eight times a day.) The control group received conventional therapy, checking their blood glucose levels less frequently and giving themselves one or two injections of insulin a day.

Since the trial has ended, all participants have faced the choice of following conventional therapy or engaging in intensive therapy, by wearing a pump or having a minimum of three injections a day and checking their blood glucose level at least…