Oscar Crofford: On the horns of a revolution  pg. 6

Drawing on his experiences in the ADA and Congress, Crofford visited each of the 29 research centers, attending banquets, speaking to participants and encouraging them “to hang in there.”

Oscar Crofford may look like a man of leisure, but breeding and selling Black Angus bulls on his family’s farm in north central Arkansas has become nearly a full-time occupation for him and his wife Jane.
Photo by Dean Dixon
The team approach seemed to work. Better than 99 percent of participants completed the study, which lasted for most of them an average of six-and-a-half years. Because of the high “adherence” rate, the study was able to end a year early.

The results, reported in 1993, showed that strict control of blood glucose dramatically delayed the onset and slowed the progression of three common complications of diabetes -- retinopathy, kidney problems and nerve damage.

There was a downside: Participants in the treatment group were more likely to experience severe hypoglycemia, episodes of low blood glucose that can be life threatening. They also gained more weight on average than those in the control group, a side effect of the more aggressive insulin therapy.

The DCCT was not the only study to demonstrate the benefits of blood glucose control, nor was it the largest. But it set the standard for how a comprehensive and complicated clinical trial should be run, Genuth says.

At Crofford’s insistence, “we made extraordinary attempts to collect good, verifiable, high-quality data, to analyze it by the best bio-statistical means we could, and then to publish our conclusions in a non-speculative, straightforward manner,” he says.

At the same time, Crofford worked with the NIDDK to ensure the study was within its budget, and met federal data management and safety requirements.

“He was astride four horses, if you will,” Genuth says, like Charlton Heston in the movie Ben Hur. “Oscar was the key person in this whole trial in getting all these horses to pull in the same direction ... What it all boils down to is leadership of a quality seldom seen in a randomized, clinical trial.”

The challenge now is to continue to educate health care providers and their patients about the importance of aggressive blood glucose control, and, through advances in technology, make it easier for patients to keep their disease in check.

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