This Article  • Full text  • PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Citing articles on ISI (5)  • Contact me when this article is cited  Related Content  • Related letters  • Related article  • Similar articles in JAMA  Topic Collections  • Nutritional and Metabolic Disorders  • Nutritional and Metabolic Disorders, Other  • Drug Therapy, Other  • Endocrine Diseases  • Diabetes Mellitus  • Alert me on articles by topic  Social Bookmarking   What's this?

Martin J. Abrahamson, MB, CHB, Discussant

JAMA. 2007;297:196-204.

Ms M, a 74-year-old woman with type 2 diabetes of 6 years' duration, has a glycated hemoglobin (HbA_1C) value of 7.4% despite taking 3 oral antidiabetic medications, as well as coexistent hypertension and abdominal obesity. She has no known microvascular or macrovascular complications of diabetes and is otherwise healthy. She is reluctant to commence insulin treatment as she dislikes the idea of injections and wonders if there are any alternate options if she is to get her HbA_1C value below 7%. The natural history of type 2 diabetes, reasons why many patients begin requiring insulin over time, rationale for tight glycemic control, and therapeutic options for Ms M are discussed.

Author Affiliation: Dr Abrahamson is Associate Professor of Medicine at Harvard Medical School and Medical Director, Joslin Diabetes Center, Boston, Mass.

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati     What's this?

RELATED LETTERS

Intensive Glucose Control in Elderly Adults
, , and
JAMA. ;297():2195-2195.
FULL TEXT  

Intensive Glucose Control in Elderly Adults

JAMA. ;297():2195-2196.
FULL TEXT  

Intensive Glucose Control in Elderly Adults--Reply

JAMA. ;297():2196-2196.
FULL TEXT  

RELATED ARTICLE

Insulin
, , and
JAMA. ;297():230-230.
FULL TEXT  

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

The Effect of Comorbid Illness and Functional Status on the Expected Benefits of Intensive Glucose Control in Older Patients with Type 2 Diabetes: A Decision Analysis
Huang et al.
ANN INTERN MED 2008;149:11-19.
ABSTRACT | FULL TEXT  

Oral Hypoglycemics and Diabetic Nephropathy
Hadler
CJASN 2008;3:159-162.
FULL TEXT  

Themed Review: Lifestyle Interventions Across the Continuum of Type 2 Diabetes: Reducing the Risks of Diabetes
Franz
AMERICAN JOURNAL OF LIFESTYLE MEDICINE 2007;1:327-334.
ABSTRACT  

Intensive Glucose Control in Elderly Adults
Hayward et al.
JAMA 2007;297:2195-2195.
FULL TEXT  

Intensive Glucose Control in Elderly Adults
Finucane
JAMA 2007;297:2195-2196.
FULL TEXT