- To measure the impact of lifestyle, physiological and genetic factors on the onset and progression of diabetic complications and to define high-risk groups who could be targeted for interventions of risk factor modification.
- To study the European variation in the incidence and progression of cardiovascular, renal, ocular and neurological complications of insulin-dependent diabetes.
- To assess the mortality experience of a European cohort of patients with IDDM.
- To design and implement a networked central information system.
- To perform a cost-benefit analysis of intensive insulin therapy for Europe.
A cross sectional survey of 3250 people with IDDM in 29 centres in Europe was funded by the EC in 1989-91. This study is a five year follow up of this original cohort. Local centres will be asked to ascertain vital status of their participants, and ascertain the cause of death in those who have died. The survivors will be invited to complete a questionnaire on medical events since the original study, lifestyle factors, medication, socioeconomic status, nutrition, pregnancies, the impact of diabetes on their lives, and knowledge about diabetes. They will also undergo a clinical examination, which will include a blood pressure measurement, resting ECG, height, weight and body fat measurements, retinal photography, a neurological examination, a urine collection for estimation of albuminuria, and blood tests for glycated haemoglobin.
Siblings of original participants who also have IDDM will be similarly invited for a clinical examination as described above. Blood from the original participant and the sibling will be taken for genetic analysis, so that the genetic and environmental effects on diabetic nephropathy in IDDM can be assessed.
A centralised information system (CIS) will be designed and implemented by the co-ordinating centre. The CIS will be used for direct data transfer to the co-ordinating centre from the local centres and from the laboratories, and will act as a repository for the final dataset. Local centres will access the dataset locally, and perform their own analyses. Support and training will be provided from the co-ordinating centre.