Improving oral pharmacologic treatment and management of type 2 diabetes

Type 2 diabetes and its associated complications impose a substantial burden on those affected by the disease and have a significant economic impact on the national health care system. Recent estimates indicate a substantial increase in diabetes prevalence in the United States in the past decade, with the largest increases occurring in minority populations. Although diet and exercise are important treatment components, they ultimately fail to control hyperglycemia in many patients. Most patients initially require oral pharmacologic therapy, and many will need multiple agents to stabilize and maintain glycemic control over time. Simplifying oral treatment regimens and reducing pill burden could improve patients' adherence to treatment substantially. Implementation of early and aggressive glycemic control along with appropriate monitoring can reduce the incidence of complications associated with diabetes, thereby improving patients' outcomes and ultimately decreasing health care costs. Toward these goals, the Diabetes Quality Improvement Project (now the National Quality Improvement Alliance) has developed measures designed to improve the care of patients with type 2 diabetes. These measures, along with new oral treatment options, may allow patients and their health care providers to achieve better glycemic control, improve adherence, and reduce the costs associated with this progressive and chronic disease.