Intensive control of blood glucose levels can modestly extend the lives of diabetes patients, a landmark 27 year follow up trial shows. The Diabetes Control and Complications Trial (DCCT) showed a 33% reduction in mortality among type 1 diabetes patients who maintained glycaemic control (HbA1c levels of around 7%) for an average of 6.5 years compared with a control group (HbA1c levels of around 8.3 %) who received conventional treatment. Writing in this week’s JAMA the authors point out that the absolute risk reduction was small at approximately 1/1000 patient-years. The results are in contrast to findings from the ACCORD trial in type 2 diabetes and give reassurance that intensive therapy in type 1 diabetes does not incur increased risk of overall mortality, the researchers said. The findings also support the emerging concept that most of the excess mortality in type 1 diabetes is mediated by the development of albuminuria, they added.