Treating Type 2 Diabetes with Respect
Authors: David M. Nathan
Journal: Annals of Internal Medicine (1999)

Editorials2 March 1999Treating Type 2 Diabetes with RespectDavid M. Nathan, MDDavid M. Nathan, MDFrom Massachusetts General Hospital, Boston, Massachusetts.Author, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-130-5-199903020-00016 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Until recently, type 2 diabetes mellitus received little respect from clinicians or patients, especially compared with its sibling, type 1 diabetes. Type 1 diabetes—characterized by onset at a young age, dramatic presentation, and acute metabolic emergencies (such as ketoacidosis)—has commanded our attention since its description more than 2000 years ago. Moreover, celebrity spokespersons have raised public awareness of this disease. Much basic and clinical diabetes research has focused on the pathophysiology and treatment of type 1 diabetes. This has resulted in the discovery and use of insulin, development of glucose monitoring devices, and the means of replacing deficient insulin secretion ...References1. Himsworth HP. Diabetes mellitus: its differentiation into insulin-sensitive and insulin insensitive types. Lancet. 1936;1:117-21. Google Scholar2. Report of the Expert Committee on the Diagnosis and Classification of Diabetes Mellitus. Diabetes Care. 1998; 21 Suppl 1:S5-S19. Google Scholar3. Nathan DM. Long-term complications of diabetes mellitus. N Engl J Med. 1993;328:1676-85. CrossrefMedlineGoogle Scholar4. Kannel WB, McGee DL. Diabetes and cardiovascular disease. The Framingham Study. JAMA. 1979;241:2035-8. CrossrefMedlineGoogle Scholar5. Panzram G. Mortality and survival in type 2 (non–insulin-dependent) diabetes mellitus. Diabetologia. 1987;30:123-31. CrossrefMedlineGoogle Scholar6. Dagogo-Jack S, Santiago JV. Pathophysiology of type 2 diabetes and modes of action of therapeutic interventions. 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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;329:977-86. CrossrefMedlineGoogle Scholar12. Cusi K, DeFronzo RA. Metformin: a review of its metabolic effects. Diabetes Reviews. 1998;6:89-131. Google Scholar13. Edelman SV, Henry RR. Insulin therapy for normalizing glycosylated hemoglobin in type II diabetes. Diabetes Reviews. 1995;3:308-34. Google Scholar Author, Article, and Disclosure InformationAffiliations: From Massachusetts General Hospital, Boston, Massachusetts.Corresponding Author: David M. Nathan, MD, Diabetes Center, Massachusetts General Hospital, Bulfinch 408, 55 Fruit Street, Boston, MA 02114. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoComparison of Bedtime Insulin Regimens in Patients with Type 2 Diabetes Mellitus Hannele Yki-Järvinen , Leena Ryysy , Kati Nikkilä , Timo Tulokas , Raimo Vanamo , and Marjatta Heikkilä Metrics Cited ByDietary advice for treatment of type 2 diabetes mellitus in adultsAddressing the Global Cardiovascular Risk of Hypertension, Dyslipidemia, Diabetes Mellitus, and the Metabolic Syndrome in the Southeastern United States, Part II: Treatment Recommendations for Management of the Global Cardiovascular Risk of Hypertension, Dyslipidemia, Diabetes Mellitus, and the Metabolic SyndromeAddition of pioglitazone or bedtime insulin to maximal doses of sulfonylurea and metformin in type 2 diabetes patients with poor glucose control: a prospective, randomized trialGroup Diabetes Patient Education: A MODEL FOR USE IN A CONTINUING CARE RETIREMENT COMMUNITYAscorbic Acid Reduces Blood Pressure and Arterial Stiffness in Type 2 DiabetesImpaired Nitric Oxide Synthase Pathway in Diabetes MellitusTreating type 2 diabetes - today's targets, tomorrow's goalsDiabetes mellitus type 2: geen tweederangsziekte 2 March 1999Volume 130, Issue 5Page: 440-441KeywordsGlucoseHemoglobinHypoglycemiaInsulinInsulin resistanceInsulin secretionPrevention, policy, and public healthType 1 diabetesType 2 diabetesWeight gain Issue Published: 2 March 1999 CopyrightCopyright © 1999 by American College of Physicians. 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