***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: OBJECTIVE To describe the beneficial long-term effects of an average of 6.5 years of intensive diabetes therapy ( INT ) in type 1 diabetes on measures of atherosclerosis , cardiac structure and function , and clinical cardiovascular events observed in the Diabetes Control and Complications Trial ( DCCT ) and the Epidemiology of Diabetes Interventions and Complications ( EDIC ) study . RESEARCH DESIGN AND METHODS The DCCT was a r and omized clinical trial of 1,441 participants assigned to receive INT or conventional therapy ( CON ) .  It was conducted between 1983–1993 with an average follow-up of 6.5 years . EDIC ( 1994–present ) is an observational follow-up of the DCCT cohort . Cardiovascular events have been recorded throughout . During EDIC common carotid intima-media thickness ( IMT ) was measured with ultrasound , coronary artery calcification with computed tomography , and cardiac structure and function with cardiac magnetic resonance imaging . RESULTS DCCT INT and lower levels of HbA1c during DCCT/EDIC were associated with thinner carotid IMT , less coronary calcification , and a lower incidence of clinical cardiovascular events including myocardial infa rct ion , stroke , and cardiac death . While there were no significant differences in cardiac structure and function between the former INT and CON groups , they were significantly associated with higher HbA1c during DCCT/EDIC . CONCLUSIONS DCCT INT and the attendant 6.5 years of lower HbA1c had long-term salutary effects on the development and progression of atherosclerosis and cardiovascular disease during the subsequent follow-up during EDIC Type 2 diabetes is a chronic illness that is increasing in epidemic proportions worldwide . Major factors contributing to the development of type 2 diabetes include obesity and poor lifestyle habits ( e.g. , excess dietary intake and limited physical activity ) . Despite the proven efficacy of lifestyle interventions and the use of multiple pharmacological agents , the economic and public health burden of type 2 diabetes remains substantial .  Obstructive sleep apnea ( OSA ) is a treatable sleep disorder that is pervasive among overweight and obese adults , who represent about two thirds of the U.S. population today . An ever-growing number of studies have shown that OSA is associated with insulin resistance , glucose intolerance and type 2 diabetes , independent of obesity . Evidence from animal and human models that mimic OSA provides potential mechanisms for how OSA may alter glucose metabolism . Up to 83 % of patients with type 2 diabetes suffer from unrecognized OSA and increasing severity of OSA is associated with worsening glucose control . However , it is still unclear whether OSA may lead to the development of diabetes over time . More data from large-scale longitudinal studies with rigorous assessment s of diabetes and OSA are needed . In addition , there is still controversy whether continuous positive airway pressure ( CPAP ) treatment of OSA  improves glucose metabolism . Large-scale r and omized-controlled trials of CPAP treatment of OSA with well-vali date d assessment s of insulin sensitivity and glucose tolerance are needed . These studies may reveal that OSA represents a novel , modifiable risk factor for the development of prediabetes and type 2 diabetes IMPORTANCE Whether mortality in type 1 diabetes mellitus is affected following intensive glycemic therapy has not been established . OBJECTIVE To determine whether mortality differed between the original intensive and conventional treatment groups in the long-term follow-up of the Diabetes Control and Complications Trial ( DCCT ) cohort . DESIGN , SETTING , AND PARTICIPANTS After the DCCT ( 1983 - 1993 ) ended , participants were followed up in a multisite ( 27 US and Canadian academic clinical centers ) observational study ( Epidemiology of Diabetes Control and Complications [ EDIC ] ) until December 31 , 2012 . Participants were 1441 healthy volunteers with diabetes mellitus who , at baseline , were 13 to 39 years of age with 1 to 15 years of diabetes duration and no or early microvascular complications , and without hypertension , preexisting cardiovascular disease , or other potentially life-threatening disease . INTERVENTIONS AND EXPOSURES During the clinical trial , participants were r and omly assigned to receive intensive therapy ( n = 711 ) aim ed at achieving glycemia as close to the nondiabetic range as safely possible , or conventional therapy ( n = 730 ) with the goal of avoiding symptomatic hypoglycemia and hyperglycemia . At the end of the DCCT , after a mean of 6.5 years , intensive therapy was taught and recommended to all participants and diabetes care was returned to personal physicians . MAIN OUTCOMES AND MEASURES Total and cause-specific mortality was assessed through annual contact with family and friends and through records over 27 years ' mean follow-up . RESULTS Vital status was ascertained for 1429 ( 99.2 % ) participants . There were 107 deaths , 64 in the conventional and 43 in the intensive group . The absolute risk difference was -109 per 100,000 patient-years ( 95 % CI , -218 to -1 ) , with lower all-cause mortality risk in the intensive therapy group ( hazard ratio [ HR ] = 0.67 [ 95 % CI , 0.46 - 0.99 ] ; P = .045 ) . Primary causes of death were cardiovascular disease ( 24 deaths ; 22.4 % ) , cancer ( 21 deaths ; 19.6 % ) , acute diabetes complications ( 19 deaths ; 17.8 % ) , and accidents or suicide ( 18 deaths ; 16.8 % ) . Higher levels of glycated hemoglobin ( HbA1c ) were associated with all-cause mortality ( HR = 1.56 [ 95 % CI , 1.35 - 1.81 per 10 % relative increase in HbA1c ] ; P < .001 ) , as well as the development of albuminuria ( HR = 2.20 [ 95 % CI , 1.46 - 3.31 ] ; P < .001 ) . CONCLUSIONS AND RELEVANCE After a mean of 27 years ' follow-up of patients with type 1 diabetes , 6.5 years of initial intensive diabetes therapy was associated with a modestly lower all-cause mortality rate when compared with conventional therapy . TRIAL REGISTRATION clinical trials.gov Identifiers : NCT00360815 and NCT00360893 
    Output:
    
T1D was associated with poorer sleep and high prevalence of OSA .
Poor sleep quality , shorter sleep duration , and OSA were associated with suboptimal glycemic control in T1D patients