An update on primary care management of type 2 diabetes

Diabetes is one of the deadliest and costliest chronic diseases in the United States. New criteria indicate a diabetes diagnosis if the fasting plasma glucose is greater than or equal to 126 mg/dl or if random plasma glucose is greater than or equal to 200 mg/dl. Use of these criteria enables early detection and treatment of the one-third of Americans with type 2 diabetes who are undiagnosed and at high risk for complications. Treatment incorporating nutrition, exercise, pharmacologic therapy, and insulin can effectively control blood glucose, hypertension, and lipids. In the managed-care environment, primary care providers will be increasingly accountable for the delivery of care based on national quality indicators. The treatment strategies discussed in this article can help clinicians meet this responsibility.