TITLE

Controlling Blood Glucose Levels in Patients with Type 2 Diabetes Mellitus

AUTHOR(S)
Woolf, Steven H.; Davidson, Mayer B.; Greenfield, Sheldon; Bell, Hanan S.; Ganiats, Theodore G.; Hagen, Michael D.; Palda, Valerie Anne; Rizza, Robert A.; Spann, Stephen J.
PUB. DATE
May 2000
SOURCE
Journal of Family Practice;May2000, Vol. 49 Issue 5, p453
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
OBJECTIVE: To review evidence about the benefit of intensive glycemic control for patients with type 2 diabetes and to develop practice recommendations. PARTICIPANTS: A 9-member panel composed of family physicians, general internists, endocrinologists, and a practice guidelines methodologist was assembled by the American Academy of Family Physicians, the American Diabetes Association, and the American College of Physicians. EVIDENCE: Admissible evidence included published randomized controlled trials and observational studies regarding the effects of glycemic control on microvascular and macrovascular complications and on adverse effects. We followed systematic search and data abstraction procedures. Greater weight was given to clinical trials and to evidence about health outcomes. CONSENSUS PROCESS: Interpretations of evidence and approval of documents were finalized by unanimous vote, with recommendations linked to evidence and not expert opinion. The full report was prepared by the chair and 2 panel members, representing each of the 3 organizations. The initial draft underwent external review by 14 diabetologists and family physicians and changes consistent with the evidence were incorporated. CONCLUSIONS: The evidence demonstrates that the risk of microvascular and neuropathic complications is reduced by lowering glucose concentrations. Whether glycemic control affects macrovascular outcomes is less clear. The potential benefits of glycemic control must be balanced against factors that either preempt benefits (eg, limited life expectancy, comorbid disease) or increase risk (eg, severe hypoglycemia). The magnitude of benefit is a function of individual clinical variables (eg, baseline glycated hemoglobin level, presence of preexisting microvascular disease). Appropriate targets for treatment should be determined by considering these factors, patients' risk profiles, and personal preferences.
ACCESSION #
3248690

 

Related Articles

  • Association of 1,5-Anhydroglucitol and 2-h Postprandial Blood Glucose in Type 2 Diabetic Patients. Stettler, Christoph; Stahl, Matthias; Allemann, Sabin; Diem, Peter; Schmidlin, Kurt; Zwahlen, Marcel; Riesen, Walter; Keller, Ulrich; Christ, Emanuel // Diabetes Care;Aug2008, Vol. 31 Issue 8, p1534 

    OBJECTIVE -- To assess the association of 1,5-anhydroglucitol (1,5-AG) with 2-h postprandial glucose values in type 2 diabetic patients followed over 12 months in an outpatient setting. RESEARCH DESIGN AND METHODS -- In 55 patients, we examined self-measured postprandial blood glucose values for...

  • Blood Glucose Fluctuation Is an Independent Risk Factor of Coronary Calcification in Japanese Patients with Type 2 Diabetes. Takebe, Noriko; Toshihiro, Makiko; Yamashina, Mitsuhiro; Ishii, Mototsugu; Fujiwara, Fumikado; Kajiwara, Takashi; Taneichi, Haruhito; Miura, Masanori; Ishida, Wataru; Takahashi, Kazuma; Kaneko, Yoshihito; Satoh, Jo // Diabetes;Jun2007 Supplement 1, Vol. 56, pA172 

    Coronary artery calcification is a risk factor for myocardial infarction in patients with type 2 diabetes. However, risk factors for coronary calcification other than traditional risk factors, such as age, male gender, waist/hip ratio (WHR), duration of diabetes, systolic BP and metabolic...

  • Soaping Up Type 2 Diabetes With Bile Acids? Staels, Bart; Prawitt, Janne // Diabetes;Dec2013, Vol. 62 Issue 12, p3987 

    The authors comment on a study which characterized the content and composition of blood bile acid (BA) in healthy subjects and diabetic patients and performed correlations with parameters of glucose homeostasis. The authors relate the correlation between the ratio of BA and the degree of insulin...

  • Is Self-Monitoring of Blood Glucose Appropriate for All Type 2 Diabetic Patients? Davis, Wendy A.; Bruce, David G.; Davis, Timothy M. E. // Diabetes Care;Aug2006, Vol. 29 Issue 8, p1764 

    OBJECTIVE -- We sought to determine whether self-monitoring of blood glucose (SMBG) is associated with better glycemic control in type 2 diabetes. RESEARCH DESIGN AND METHODS -- We used cross-sectional and longitudinal data from type 2 diabetic participants in the observational, community-based...

  • The Relationship between Serum Osteocalcin Concentration and Glucose Metabolism in Patients with Type 2 Diabetes Mellitus. Qingqing Wang; Beibei Zhang; Yulan Xu; Hongdi Xu; Nan Zhang // International Journal of Endocrinology;2013, p1 

    To study the correlations between serum osteocalcin and glucose metabolism in patients with type 2 diabetes, 66 cases were collected to determine total osteocalcin, undercarboxylated osteocalcin, fasting blood glucose, fasting insulin, and HbA1c. Osteocalcin concentrations were compared between...

  • Glimepiride 1 mg, 2mg, and 4 mg tablet.  // Pharmacy Today;Nov2005, Vol. 11 Issue 11, p4 

    The article reports on the availability of Glimepiride 1 mg, 2 mg, and 4 mg tablets in the market. Glimepiride is indicated as an adjunct to diet and exercise to lower the blood glucose in patients with type 2 diabetes mellitus whose hyperglycemia cannot be controlled by diet and exercise alone.

  • Estimation of Salivary Glucose and Glycogen Content in Exfoliated Buccal Mucosal Cells of Patients with Type II Diabetes Mellitus. RAVINDRAN, RATHY; MOOTHEDATHU GOPINATHAN, DEEPA; SUKUMARAN, SUNIL // Journal of Clinical & Diagnostic Research;May2015, Vol. 9 Issue 5, p89 

    Background: Diabetes mellitus is a common metabolic disorder which shows an increasing incidence worldwide. Constant monitoring of blood glucose in diabetic patient is required which involves painful invasive techniques. Saliva is gaining acceptance as diagnostic tool for various systemic...

  • Is it time for insulin?  // Journal of Family Practice;Oct2011, Vol. 60 Issue 10, p581 

    The article offers several insights regarding the effectiveness of insulin on the physical aspects of type 2 diabetes patients. It mentions that the importance of insulin may help control the blood sugar where exercise and diet were not working. It adds several tips in preventing the risk of...

  • Reversal of nonalcoholic hepatic steatosis, hepatic insulin resistance, and hyperglycemia by moderate weight reduction in patients with type 2 diabetes. Petersen, Kitt Falk; Dufour, Sylvie; Befroy, Douglas; Lehrke, Michael; Hendler, Rosa E.; Shulman, Gerald I. // Diabetes;Mar2005, Vol. 54 Issue 3, p603 

    To examine the mechanism by which moderate weight reduction improves basal and insulin-stimulated rates of glucose metabolism in patients with type 2 diabetes, we used (1)H magnetic resonance spectroscopy to assess intrahepatic lipid (IHL) and intramyocellular lipid (IMCL) content in conjunction...

Share

Read the Article

Courtesy of THE LIBRARY OF VIRGINIA

Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics