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Diabetes is one of the most common illnesses encountered by internists. An estimated 23.6 million persons have diabetes in the United States, and only 17.9 million of these cases have been diagnosed (1). The incidence of diabetes is increasing because of the aging and changing ethnic mix of the population and because of worsening obesity. On the basis of current trends, the prevalence of diabetes is expected to nearly double by 2030 (2). Although diabetes care is improving by many measures, complications are still common, and diabetes remains the leading cause of visual loss, amputation, and end-stage renal disease in the United States (1). In addition, diabetes is a substantial risk factor for atherosclerotic disease, which is the leading cause of morbidity, mortality, and expenditures in persons with diabetes.
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