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Achieving glycemic control: cornerstone in the treatment of patients with multiple metabolic risk factors

Craig W Spellman1

  • 1Department of Internal Medicine, Texas Tech University Health Sciences Center, Odessa, TX 79763-4206, USA. craig.spellman@ttuhsc.edu

The Journal of the American Osteopathic Association
|May 20, 2009
PubMed

Insights

Achieving tight glycemic control through active patient participation is key for managing diabetes mellitus (T2DM and T1DM). While beneficial for preventing microvascular complications, its cardiovascular benefits vary by patient age and diabetes type.

Area of Science:

  • Endocrinology and Metabolism
  • Clinical Diabetes Research

Background:

  • Glycosylated hemoglobin (HbA1c) control is vital for managing diabetes mellitus (T2DM).
  • HbA1c serves as the benchmark for assessing long-term glucose control and preventing end-organ damage.

Purpose of the Study:

  • To review clinical trial data on the benefits of tight glycemic control in type 1 diabetes mellitus (T1DM) and T2DM.
  • To examine treatment strategies for achieving and maintaining glycemic control.

Main Methods:

  • Systematic review of published clinical trials.
  • Analysis of data regarding glycemic control and its impact on diabetes-related complications.

Main Results:

  • Tight glucose control reduces risks of retinopathy, nephropathy, and neuropathy in both T1DM and T2DM.
  • Early aggressive insulin therapy in younger T1DM patients decreased myocardial infarction, stroke, and mortality.
  • Benefits of tight glycemic control for cardiovascular events are less clear in older T2DM patients with long-standing disease.

Conclusions:

  • Successful diabetes management requires active patient involvement and education in disease self-management.
  • Physicians must empower patients with knowledge of effective therapeutic strategies for optimal glycemic control.

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