Glycemic control in type 2 diabetes: Time for an evidence-based about-face?

Victor M. Montori, Mercè Fernández-Balsells

Research output: Contribution to journalReview article

130 Scopus citations

Abstract

Some diabetes guidelines set low glycemic control goals for patients with type 2 diabetes mellitus (such as a hemoglobin A1c level as low as 6.5% to 7.0%) to avoid or delay complications. Our review and critique of recent large randomized trials in patients with type 2 diabetes suggest that tight glycemic control burdens patients with complex treatment programs, hypoglycemia, weight gain, and costs and offers uncertain benefits in return. We believe clinicians should prioritize supporting well-being and healthy lifestyles, preventive care, and cardiovascular risk reduction in these patients. Glycemic control efforts should individualize hemoglobin A1c targets so that those targets and the actions necessary to achieve them reflect patients' personal and clinical context and their informed values and preferences.

Original languageEnglish (US)
Pages (from-to)803-808
Number of pages6
JournalAnnals of internal medicine
Volume150
Issue number11
DOIs
StatePublished - Jun 2 2009

ASJC Scopus subject areas

  • Internal Medicine

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