Skip Navigation
Menu
Editorials |1 November 1997

Glucose Control in Type 2 Diabetes Mellitus

Jay S. Skyler, MD

Article, Author, and Disclosure Information
Author, Article, and Disclosure Information
Copyright ©2004 by the American College of Physicians
2004
  • University of Miami; Miami, FL 33136 Requests for Reprints: Jay S. Skyler, MD, University of Miami, Suite 1012 East, 1500 NW 12th Avenue, Miami, FL 33136.
×
FULL TEXT
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 Diabetes Control and Complications Trial (DCCT) [1]. The DCCT is the most important clinical study ever conducted in the field of diabetes. This multicenter randomized, controlled clinical trial showed that intensive treatment of type 1 diabetes, with the goal of meticulous glycemic control, dramatically decreases the frequency and severity of retinopathy, nephropathy, and neuropathy. Yet, the extent to which the DCCT results apply to patients with type 2 diabetes has been questioned. The arguments that it does apply are three.
First, extensive epidemiologic studies (as exemplified by the Wisconsin study [2, 3], with its 10 years of follow-up) have shown a strong and consistent relation between glycemia and the incidence and progression of microvascular (diabetic retinopathy, loss of vision, and nephropathy) and macrovascular (amputation and death from cardiovascular disease) complications in patients with type 1 or type 2 diabetes [2, 3]. The similar outcomes in type 1...
FULL TEXT
PDF
Not Available
Citations
Citation

Skyler JS. Glucose Control in Type 2 Diabetes Mellitus. Ann Intern Med. 1997;127:837–839. doi: https://doi.org/10.7326/0003-4819-127-9-199711010-00011

Download citation file:

© 2020

×
Permissions

Published: Ann Intern Med. 1997;127(9):837-839.

DOI: 10.7326/0003-4819-127-9-199711010-00011

10 Citations

Related Articles
Effect of Antihyperglycemic Agents Added to Metformin and a Sulfonylurea on Glycemic Control and Weight Gain in Type 2 Diabetes: A Network Meta-analysis
Annals of Internal Medicine; 154 (10): 672-679
Nurse Case Management To Improve Glycemic Control in Diabetic Patients in a Health Maintenance Organization: A Randomized, Controlled Trial
Annals of Internal Medicine; 129 (8): 605-612
More Than a Case Manager
Annals of Internal Medicine; 129 (8): 654-656
Estimated Benefits of Glycemic Control in Microvascular Complications in Type 2 Diabetes
Annals of Internal Medicine; 127 (9): 788-795
View MoreView Less

Journal Club
Review: In diabetes, intensive and standard glycemic control do not differ for end-stage kidney disease or death
Annals of Internal Medicine; 167 (8): JC47
Guideline: In type 2 diabetes, ACP recommends metformin monotherapy if drugs are needed for glycemic control
Annals of Internal Medicine; 166 (8): JC39
Review: In adult outpatients, nurse-managed protocols improve hemoglobin A1c levels and blood pressure
Annals of Internal Medicine; 161 (12): JC6
In uncontrolled type 2 diabetes, CBT improved glycemic control and reduced depression
Annals of Internal Medicine; 161 (4): JC3
View MoreView Less

Related Point of Care
Type 2 Diabetes
Annals of Internal Medicine; 171 (9): ITC65-ITC80
Type 2 Diabetes
Annals of Internal Medicine; 162 (5): ITC1
Type 2 Diabetes
Annals of Internal Medicine; 152 (5): ITC3-1
Type 2 Diabetes
Annals of Internal Medicine; 146 (1): ITC1-1
View MoreView Less

Related Topics
Cardiology
Coronary Risk Factors
Diabetes
Endocrine and Metabolism

Cardiology, Coronary Risk Factors, Diabetes, Endocrine and Metabolism.

CONTINUE WITH LIMITED ACCESS
Annals of Internal Medicine
To receive access to the full text of freely available articles, alerts, and more. You will be directed to acponline.org to complete your registration.
×
acp link acp
silverchair link silverchair

Copyright © 2020 American College of Physicians. All Rights Reserved.

Print ISSN: 0003-4819 | Online ISSN: 1539-3704

Privacy Policy

|

Conditions of Use

This site uses cookies. By continuing to use our website, you are agreeing to our privacy policy. | Accept
×

You need a subscription to this content to use this feature.

×
PDF Downloads Require Access to the Full Article.
Annals of Internal Medicine
To receive access to the full text of freely available articles, alerts, and more. You will be directed to acponline.org to complete your registration.
×
Access to this Free Content Requires Users to be Registered and Logged In. Please Choose One of the Following Options
Annals of Internal Medicine
To receive access to the full text of freely available articles, alerts, and more. You will be directed to acponline.org to complete your registration.
×