Legacy Effects from DCCT and UKPDS: What They Mean and Implications for Future Diabetes Trials

The United Kingdom Prospective Diabetes Study (UKPDS) and the Diabetes Chronic Complications Trial (DCCT) are two landmark trials that convincingly demonstrated that tight glycemic control has beneficial effects on microvascular end points. These studies also revealed a legacy effect, which is a sustained benefit with respect to cardiovascular disease outcomes seen long after the conclusion of the trial. We discuss possible molecular mechanisms that could play a role in causing the legacy effect.