HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Spellman, C. W. Search for Related Content PubMed PubMed Citation Articles by Spellman, C. W.

Dr Spellman is associate dean for research and professor of medicine in the Department of Internal Medicine, Division of Endocrinology, and director of the Center for Diabetes and Metabolic Disorders at Texas Tech University Health Sciences Center at Odessa, Tex. He is also chairman of the Medical Professionals and Health Professionals Committee of the Texas Diabetes Council.

Address correspondence to Craig W. Spellman, DO, PhD, 701 W 5th St, Texas Tech University Health Sciences Center, Department of Internal Medicine, Odessa, TX 79763-4206. E-mail: craig.spellman{at}ttuhsc.edu

The control of glycosylated hemoglobin (HbA_1c) levels is crucial to the successful treatment of patients with diabetes mellitus (T2DM). Glycemic control is a cornerstone for reducing end-organ disease, and HbA_1c is the benchmark for defining glucose control over long durations. The author reviews available information from published clinical trials regarding the benefits of tight glycemic control in type 1 diabetes mellitus (T1DM) and type 2 diabetes mellitus (T2DM). He notes that published data support the use of tight glucose control for reducing risks of retinopathy, nephropathy, and neuropathy in both patients with T1DM and patients with T2DM. He also notes that early aggressive insulin management of younger individuals with T1DM led to reductions in the incidence of myocardial infarction (MI), stroke, and death. However, published data do not clearly support benefits of tight glucose control for the prevention of cardiovascular events in older patients with long-standing T2DM.

The author also reviews recommended treatments for achieving and maintaining glycemic control in patients. He concludes that the most successful treatment requires that physicians encourage patients to actively participate in the management of their own disease, and that physicians provide patients with opportunities to learn the cornerstones of effective therapy.