The Why and Wherefore of Glucose Control in Type 2 Diabetes Mellitus

John W. Hare, MD

Insulin was first used to treat diabetes mellitus (DM) in 1922. Most of the diagnosed cases of DM then were symptomatic and, thus, type 1 DM. Blood glucose testing generally was not done unless the patient developed symptoms; as a result, most cases of type 2 DM went undiagnosed. As insulin therapy rapidly became available, deaths from diabetic ketoacidosis (DKA) plummeted. In the mid-20th century it became apparent that, although insulin therapy conferred an immediate survival benefit, it allowed the later development of vascular complications. By the mid-1940s, most deaths from diabetes were cardiorenal in nature and few were ascribed to DKA.

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Implications of the ADA/EASD Consensus Algorithm for Treatment of Type 2 Diabetes Mellitus for Primary Care Practitioners: Four Pivotal Points
Charles F. Shaefer, Jr., MD, FACP, FCCP

Type 2 diabetes mellitus (DM) is appearing in adults at an epidemic rate. Primary care clinicians will, out of necessity, provide diabetes care for most patients with type 2 DM. A systematic care plan will contribute to effective and cost-efficient management of the increasing number of diabetic patients presenting in the primary care setting.

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Postprandial Physiology and the Pathogenesis of Type 2 Diabetes Mellitus
Stephen N. Davis, MD, FRCP

Patients with type 2 diabetes mellitus (DM) have an increased risk of cardiovascular morbidity and mortality. Recent studies implicate postprandial hyperglycemia as an important driver of the increased risk of cardiovascular disease in patients with type 2 DM or prediabetes.

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