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Drug Therapy for Patients With Type 2 Diabetes
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To the Editor: In his Scientific Review article about treatment of type 2 diabetes, Dr Inzucchi1 advocates achieving glycemic control by using any available antihyperglycemic therapy. He bases this recommendation on decreased rates of microvascular complications observed in the Diabetes Control and Complications Trial (DCCT)2 and the United Kingdom Prospective Diabetes Study (UKPDS).3
An ancillary study of the DCCT, however, showed that intensive drug treatment of patients with type 1 diabetes resulted in greater weight gain than conventional treatment.4 With intensive treatment, subjects in the highest quartile of weight gain had the highest body mass index, blood pressure, and levels of triglycerides, total cholesterol, and low-density lipoprotein cholesterol. In addition, this group had a higher waist-to-hip ratio, a higher percentage of their cholesterol as very low-density lipoprotein and dense low-density lipoprotein fractions, and lower high-density lipoprotein cholesterol compared with those in the first quartile.
These findings suggest that changes in . . . [Full Text of this Article]
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