[Type 2 diabetes in the middle aged. Strict goals from the very beginning!]

Type 2 diabetes mellitus in the middle-aged, that is the onset of diabetes before the age of 65, accounts for fifty percent of all diabetic patients. Because of their relatively long life expectancy, this age group carries a particular risk of experiencing microvascular and macrovascular sequelae. In view of this, the following therapeutic objectives must be strictly applied: near-normalization of blood glucose, HbA1c (< 7.0%), blood pressure (< 140/90 mmHg), LDL cholesterol (< 130/100 mg/dl). Permanent weight reduction in the initial phase may delay disease progression for years. Guidelines issued by the German Diabetes Association require that middle-aged type 2 diabetics should receive 20-24 hours of structured instruction in closed groups, since the brief information provided by the doctor's assistant is inadequate in this age group.