An Uncompromising Approach to Achieving Glycemic Goals

While the prevalence of diabetes isincreasing in epidemic proportions,there is now evidence that effectivetreatment regimens significantlyreduce the risk of debilitating long-term outcomes. This underlines the urgency of develop-ing a new approach to diabetes care. The sequelae of diabetes include microvascular and macrovascular disease, and the most serious consequence is coronary heart disease. In the United States, the number of deaths from complica-tions of diabetes increases each year, with 224000 in 2005.1 Diabetes is the sixth leading cause of death in the United States.1 In addition, the growing numbers of people diagnosed with prediabetes and metabolic syndrome are at increased risk for cardiovascular disease. For persons with diabetes, there is now evidence that achieving treat-ment goals, including glucose targets, reduces the onset and progression of vascular complications. Despite this evidence, a large number of persons with diabetes are not meeting those treatment goals, putting them at high risk of diabetes-related morbidity and mortality, includ-ing vascular complications and early death. This article emphasizes optimization of the use of new diabetes medications and management tools in a program of ear-lier, more aggressive, and more comprehensive diabetes treatment. Only an uncompromising approach to achiev-ing treatment goals will reduce the risk of debilitating long-term outcomes, including coronary heart disease