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Glycemic control: arguments for and against.

R M Bikowski1, C K Smith

  • 1Department of Family and Community Medicine, Eastern Virginia Medical School, Norfolk.

Primary Care
|June 1, 1988
PubMed
Summary
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Hyperglycemia contributes to long-term diabetes complications, but tight blood sugar control shows no definitive evidence of preventing microvascular or macrovascular disease. Future studies may clarify benefits, emphasizing individualized patient care.

Area of Science:

  • Endocrinology
  • Metabolic Diseases
  • Diabetology

Background:

  • Hyperglycemia is linked to long-term diabetes complications.
  • Genetic predisposition plays a role in complication development.
  • The degree of hyperglycemia correlates with complication severity and incidence.

Purpose of the Study:

  • To evaluate if tight glycemic control can prevent or minimize long-term diabetes complications.
  • To review current literature on the efficacy of intensive glucose management.

Main Methods:

  • Literature review of recent studies on diabetes complications.
  • Analysis of the correlation between hyperglycemia and complication development.
  • Consideration of ongoing research, such as studies at the NIH.

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Main Results:

  • No definitive evidence currently exists that tight glycemic control prevents typical microvascular or macrovascular complications.
  • The degree of hyperglycemia is well-correlated with complication severity and incidence.

Conclusions:

  • While current evidence is not definitive, future studies are likely to show benefits of tight glycemic control.
  • Clinicians must balance the costs and benefits of tight control, especially in type II diabetes.
  • Prudent management involves achieving the best possible glycemic control within patient resources, addressing risk factors like hypertension and smoking, and avoiding undue risks.