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February 5, 1997

Cost-effectiveness of Intensive Insulin Therapy in the Diabetes Control and Complications Trial

Author Affiliations

Centers for Disease Control and Prevention Atlanta, Ga

JAMA. 1997;277(5):374. doi:10.1001/jama.1997.03540290026018

To the Editor.  —The Diabetes Control and Complications Trial (DCCT) Research Group1 has recently published data that suggest that intensive insulin therapy for management of insulin-dependent diabetes mellitus (IDDM) may be well within the range of cost-effectiveness considered to represent good value. The DCCT group needs to be commended for such a thorough analysis and for providing yet another dimension to our understanding of the public health aspects of diabetes. Economic analysis alongside randomized clinical trials offer another important perspective to trial findings and can provide a rational means of assessing the implications of translating research information into practice.Given the importance of this study, it would be useful to have the insights of the authors regarding 3 aspects of the analysis. First, while clinical trials may offer data that are internally valid, they are often not readily generalizable—an issue that may be particularly important when it comes to