Advanced Internal Medicine Group, PC, New York.
Internal Medicine, NYU Winthrop University Hospital-Garden City Primary Care, New York.
Diabetes Obes Metab. 2018 Aug;20(8):1809-1811. doi: 10.1111/dom.13325. Epub 2018 May 10.
The management of type 2 diabetes has become increasingly controversial. Tight control has been advocated for years; however, there was a recent revision published by the American College of Physicians in which limitations were made to liberalize glycaemic goals for most diabetics, targeting a level between 7% and 8%. In recent years, the evolution of diabetes care has been such that more potent drugs, with low risk of hypoglycaemia when used in the absence of insulin or secretagogues, have made their way into the market place. Use of such agents has made it easier to achieve greater glycaemic control reasonably safely. Unfortunately, it appears that there has been a significant amount of inertia over the past decade, which continues to persist. Relaxing the glycaemic control targets, as recommended by the American College of Physicians, may only help to propagate this inertia.
2 型糖尿病的管理变得越来越有争议。多年来一直提倡严格控制,但最近美国医师学院发表的一篇文章对大多数糖尿病患者的血糖目标放宽进行了限制,目标值定在 7%至 8%之间。近年来,糖尿病治疗的发展使得更多的强效药物进入市场,这些药物在没有胰岛素或促分泌素的情况下使用时低血糖风险较低。这些药物的使用使得更容易实现更大程度的血糖控制,而且相对安全。不幸的是,在过去十年中,似乎存在大量的惯性,这种惯性仍在持续。正如美国医师学院所建议的那样,放宽血糖控制目标可能只会助长这种惯性。