The Triumph of Innovation and the Hard Work of Caring for Patients With Diabetes
Authors: Victor M. Montori, Rene Rodriguez-Gutierrez
Journal: Annals of Internal Medicine (2015)

Editorials19 January 2016The Triumph of Innovation and the Hard Work of Caring for Patients With DiabetesVictor M. Montori, MD, MSc and Rene Rodriguez-Gutierrez, MDVictor M. Montori, MD, MScFrom Mayo Clinic, Rochester, Minnesota.Search for more papers by this author and Rene Rodriguez-Gutierrez, MDFrom Mayo Clinic, Rochester, Minnesota.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/M15-2610 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Patients with type 2 diabetes mellitus and their clinicians face an unprecedented and growing number of antihyperglycemic treatment options. Although the resulting choices improve the chances that patients can find a drug that best addresses their situation, this triumph of innovation has increased the complexity of diabetes care.Determining what is best for a patient is hard for 3 main reasons. The evidence from clinical research may not indicate how the available options affect the issues that matter most to each patient. Even when the evidence is reliable and complete—which it often is not—and when clinically sensible options are easy ...References1. Elwyn G, Lloyd A, May C, van der Weijden T, Stiggelbout A, Edwards A, et al. Collaborative deliberation: a model for patient care. Patient Educ Couns. 2014;97:158-64. [PMID: 25175366] doi:10.1016/j.pec.2014.07.027 CrossrefMedlineGoogle Scholar2. Tamhane S, Rodriguez-Gutierrez R, Hargraves I, Montori VM. Shared decision-making in diabetes care. Curr Diab Rep. 2015;15:112. [PMID: 26458383] doi:10.1007/s11892-015-0688-0 CrossrefMedlineGoogle Scholar3. May C, Montori VM, Mair FS. We need minimally disruptive medicine. BMJ. 2009;339:b2803. [PMID: 19671932] doi:10.1136/bmj.b2803 CrossrefMedlineGoogle Scholar4. Mair FS, May CR. Thinking about the burden of treatment [Editorial]. BMJ. 2014;349:g6680. [PMID: 25385748] doi:10.1136/bmj.g6680 CrossrefMedlineGoogle Scholar5. Zaccardi F, Htike ZZ, Webb DR, Khunti K, Davies MJ. Benefits and harms of once-weekly glucagon-like peptide-1 receptor agonist treatments. A systematic review and network meta-analysis. Ann Intern Med. 2016;164:102-13. doi:10.7326/M15-1432 LinkGoogle Scholar6. Montori VM, Jaeschke R, Schünemann HJ, Bhandari M, Brozek JL, Devereaux PJ, et al. Users' guide to detecting misleading claims in clinical research reports. BMJ. 2004;329:1093-6. [PMID: 15528623] CrossrefMedlineGoogle Scholar7. Puhan MA, Schünemann HJ, Murad MH, Li T, Brignardello-Petersen R, Singh JA, et al; GRADE Working Group. A GRADE Working Group approach for rating the quality of treatment effect estimates from network meta-analysis. BMJ. 2014;349:g5630. [PMID: 25252733] doi:10.1136/bmj.g5630 CrossrefMedlineGoogle Scholar8. Mullan RJ, Montori VM, Shah ND, Christianson TJ, Bryant SC, Guyatt GH, et al. The diabetes mellitus medication choice decision aid: a randomized trial. Arch Intern Med. 2009;169:1560-8. [PMID: 19786674] doi:10.1001/archinternmed.2009.293 CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAuthors: Victor M. Montori, MD, MSc; Rene Rodriguez-Gutierrez, MDAffiliations: From Mayo Clinic, Rochester, Minnesota.Grant Support: The authors have no financial relations with any for-profit organization. All grants to support their work and the work of their research unit come only from the Mayo Clinic Foundation for Medical Education and Research and nonprofit and governmental granting institutions.Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M15-2610.Corresponding Author: Victor M. Montori, MD, MSc, Knowledge and Evaluation Research Unit, Divisions of Endocrinology, Diabetes, Metabolism and Nutrition Research, Department of Medicine, Mayo Clinic, 200 1st Street Southwest, Rochester, MN 55905; e-mail, montori.victor@mayo.edu.Current Author Addresses: Drs. Montori and Rodriguez-Gutierrez: Knowledge and Evaluation Research Unit, Divisions of Endocrinology, Diabetes, Metabolism and Nutrition Research, Department of Medicine, Mayo Clinic, 200 1st Street Southwest, Rochester, MN 55905.This article was published at www.annals.org on 8 December 2015. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byNonglycemic Effects of GLP-1 Agonists: From a Starling to Lizards to PeopleClinical Use of Continuous Glucose Monitoring in Adults with Type 2 DiabetesGlucagon-Like Peptide-1 Receptor Agonists and Diabetic Cardiovascular Disease: Implications of the LEADER Study12. Diabetes 19 January 2016Volume 164, Issue 2Page: 127-128KeywordsDisclosureDrugsEndocrinologyHemoglobinHypoglycemicsNetwork analysisNutritionRunningSafetyType 2 diabetes ePublished: 8 December 2015 Issue Published: 19 January 2016 Copyright & PermissionsCopyright © 2015 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...