Glucose Control in Type 2 Diabetes Mellitus (1997)

Editorials1 November 1997Glucose Control in Type 2 Diabetes MellitusJay S. Skyler, MDJay S. Skyler, MDUniversity of Miami; Miami, FL 33136Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-127-9-199711010-00011 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail The burden of diabetes mellitus is a consequence of the devastating chronic complications of the disease. In the United States, diabetes remains the leading cause of new blindness in adults, end-stage renal disease resulting in dialysis or transplantation, and nontraumatic amputations. Today, however, future blindness, kidney failure, and amputation should be markedly lessened as we implement preventive strategies, including attainment of meticulous glycemic control, laser photocoagulation, and early introduction of therapy with angiotensin-converting enzyme inhibitors.In patients with type 1 diabetes, the debate over the role of careful glycemic control in the evolution of complications has ended, thanks to the ...References1. The effect of intensive treatment of diabetes on the development and progression of long-term complications in insulin-dependent diabetes mellitus. The Diabetes Control and Complications Trial Research Group. N Engl J Med. 1993; 329:683-9. Google Scholar2. Klein R. Hyperglycemia and microvascular and macrovascular disease in diabetes. Diabetes Care. 1995; 18:258-68. Google Scholar3. Klein R, Klein BE, Moss SE. Relation of glycemic control to diabetic microvascular complications in diabetes mellitus. Ann Intern Med. 1996; 124(1 Pt 2):90-6. Google Scholar4. The relationship of glycemic exposure (HbA1c) to the risk of development and progression of retinopathy in the Diabetes Control and Complications Trial. Diabetes. 1995; 44:968-83. Google Scholar5. Skyler JS. Diabetic complications. The importance of glucose control. Endocrinol Metab Clin North Am. 1996; 25:243-54. Google Scholar6. Ohkubo Y, Kishikawa H, Araki E, Miyata T, Isami S, Motoyoshi S, et al. Intensive insulin therapy prevents the progression of diabetic microvascular complications in Japanese patients with non–insulin-dependent diabetes mellitus: a randomized prospective 6-year study. Diabetes Res Clin Pract. 1995; 28:103-17. Google Scholar7. Standards of medical care for patients with diabetes mellitus. American Diabetes Association. Diabetes Care. 1997; 20(Suppl 1):S5-13. Google Scholar8. Turner R, Cull C, Holman R. United Kingdom Prospective Diabetes Study 17: a 9-year update of a randomized, controlled trial on the effect of improved metabolic control on complications in non–insulin-dependent diabetes mellitus. Ann Intern Med. 1996; 124(1 Pt 2):136-45. Google Scholar9. Eastman RC, Javitt JC, Herman WH, Dasbach EJ, Zbrozek AS, Dong F, et al. Model of complications of NIDDM. I. Model construction and assumptions. Diabetes Care. 1997; 20:725-34. Google Scholar10. Eastman RC, Javitt JC, Herman WH, Dasbach EJ, Copley-Merriman C, Maier W, et al. Model of complications of NIDDM. II. Analysis of the health benefits and cost-effectiveness of treating NIDDM with the goal of normoglycemia. Diabetes Care. 1997; 20:735-44. Google Scholar11. Vijan S, Hofer TP, Hayward RA. Estimated benefits of glycemic control in microvascular complications in type 2 diabetes. Ann Intern Med. 1997; 127:788-95. Google Scholar12. Testa MA, Simonson DC. Health economic benefits of improved glycemic control in NIDDM [Abstract]. Diabetes. 1997; 46(Suppl 1):37A. Google Scholar13. Eastman R, Flemming B, Vinicor F, Pogach L. Costs and consequences of ADA treatment targets [Abstract]. Diabetes. 1997; 46(Suppl 1):35A. Google Scholar Author, Article, and Disclosure InformationAffiliations: University of Miami; Miami, FL 33136Corresponding Author: Jay S. Skyler, MD, University of Miami, Suite 1012 East, 1500 NW 12th Avenue, Miami, FL 33136. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoEstimated Benefits of Glycemic Control in Microvascular Complications in Type 2 Diabetes Sandeep Vijan , Timothy P. Hofer , and Rodney A. Hayward Metrics Cited byRebuttal from Dr Morris et alVariation in Diabetes Care Among States: Do patient characteristics matter?Quality of life and effectiveness of diabetes care in three different settings in LeuvenBarriers to Control of Blood Glucose in Diabetes MellitusInsulin resistance and antidiabetic drugsTREATMENT OF TYPE 2 DIABETES MELLITUS 1 November 1997Volume 127, Issue 9Page: 837-839KeywordsBlindnessClinical trialsHealth careHealth economicsHemoglobinNeuropathyRenal failureRetinopathyType 1 diabetesType 2 diabetes Issue Published: 1 November 1997 Copyright & PermissionsCopyright © 1997 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...