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April 10, 1996

The Medical Outcomes Study

Author Affiliations

Mt Sinai School of Medicine New York, NY

JAMA. 1996;275(14):1083-1084. doi:10.1001/jama.1996.03530380025015

To the Editor.  —It is unclear that the conclusions drawn from the MOS1 are applicable to current and future management of patients with NIDDM. Not only was the number of patients treated by endocrinologists inadequate for meaningful statistical analysis, but the 2- and 4-year outcomes in NIDDM may be too short for significant differences to be manifest. It is unclear that any intervention in a population of 60-year-old patients with NIDDM would influence mortality within 7 years except within subgroups, which this study does not analyze.The Diabetes Control and Complications Trial2 of intensified treatment for patients with insulin-dependent diabetes mellitus was published just as the study by Dr Greenfield and colleagues1 ended. It required 5 to 7 years to demonstrate significant differences in complications and even then did not reach statistical significance for some measures. No effect on mortality was described. The benefits of intensified treatment