Long-term Glycemic Control in Patients with Diabetes?

Diabetes is at epidemic levels, with the costs of treatment placing a significant economic burden on healthcare systems worldwide. Most people with type 2 diabetes are failing to achieve optimal blood glucose control, leading to disease progression and the onset of debilitating and expensive complications, including heart disease, amputations, blindness and kidney failure. To achieve adequate blood glucose control, all patients with type 1 diabetes need exogenous insulin, and most with type 2 diabetes will also eventually require insulin replacement therapy. Despite the fact that insulin is the most effective glucose-lowering treatment available, studies using US and UK medical databases indicate that more than half of the patients who no longer achieve glycemic control with oral medications wait four years or more to initiate subcutaneous insulin therapy.