Comments on: Tight diabetes guidelines and the "glitazone" problem http://www.kevinmd.com/blog/2007/09/tight-diabetes-guidelines-and-glitazone.html Wed, 15 Feb 2012 00:27:00 +0000 hourly 1 By: Christine-Meganhttp://www.kevinmd.com/blog/2007/09/tight-diabetes-guidelines-and-glitazone.html#comment-80005 Christine-Megan Fri, 14 Sep 2007 01:37:00 +0000 http://clients.emmense.com/kevinmd/2007/09/tight-diabetes-guidelines-and-the-glitazone-problem.html#comment-80005 Gah, I couldn't agree less! <br/><br/>Instead of using 3 oral medications and still having sub-optimal results, I think the focus should be on adding insulin sooner. But I think many physicians don't want to do this. And certainly many patients don't. So instead we get sub-optimal control leading to heart disease on a drug that leads to heart disease.<br/><br/>I do NOT think the a1c targets should be lessened. 7% is the ADA's goal. The AACE recommends 6.5%. 8% is an average glucose of nearly 210. Research I've seen suggests that damage occurs over 150. Some feel it happens even lower.<br/><br/>So maybe we'll cut the risk of side effects from OA's, we'll just kill their kidneys, eyes, and peripheral circulation, and possibly still end up with heart disease.<br/><br/>Bad plan imho. Gah, I couldn’t agree less!

Instead of using 3 oral medications and still having sub-optimal results, I think the focus should be on adding insulin sooner. But I think many physicians don’t want to do this. And certainly many patients don’t. So instead we get sub-optimal control leading to heart disease on a drug that leads to heart disease.

I do NOT think the a1c targets should be lessened. 7% is the ADA’s goal. The AACE recommends 6.5%. 8% is an average glucose of nearly 210. Research I’ve seen suggests that damage occurs over 150. Some feel it happens even lower.

So maybe we’ll cut the risk of side effects from OA’s, we’ll just kill their kidneys, eyes, and peripheral circulation, and possibly still end up with heart disease.

Bad plan imho.

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