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The Other Side of Quality Improvement in Diabetes for Seniors

The Other Side of Quality Improvement in Diabetes for Seniors COMMENTARY LESS IS MORE The Other Side of Quality Improvement in Diabetes for Seniors A Proposal for an Overtreatment Glycemic Measure HE MANAGEMENT OF demonstrated that there was no car- trends of severe hypoglycemia in the diabetes poses chal- diovascular benefit associated with United States is not known, al- lenges at all levels, tight control of glycemia (achieved though a population study from Ger- from affected indi- hemoglobin A of 6.4%, 6.4%, and many found a substantial increase 1c T viduals to society as 6.9% for ACCORD, ADVANCE, and between 1997-2000 and 2007- a whole. Microvascular complica- VADT, respectively) compared with 2010. Also, comorbid medical and tions of diabetes have been attrib- control arms (7.5%, 7.0%, and 8.4% mental health conditions that could uted to poor glycemic control since for ACCORD, ADVANCE, and affect the risk of hypoglycemia are the Joslin era. This hypothesis was VADT, respectively). In fact, highly prevalent among persons confirmed for patients with type 1 ACCORD was stopped prematurely older than 65 years. diabetes mellitus by the results of the because of increased mortality in the Another factor is also altering the Diabetes Control and Complica- intensive control group, an increase landscape: increasing recognition tions http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png JAMA Internal Medicine American Medical Association

The Other Side of Quality Improvement in Diabetes for Seniors

JAMA Internal Medicine , Volume 172 (19) – Oct 22, 2012

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Publisher
American Medical Association
Copyright
Copyright 2012 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Restrictions Apply to Government Use.
ISSN
2168-6106
eISSN
2168-6114
DOI
10.1001/archinternmed.2012.4392
pmid
22965316
Publisher site
See Article on Publisher Site

Abstract

COMMENTARY LESS IS MORE The Other Side of Quality Improvement in Diabetes for Seniors A Proposal for an Overtreatment Glycemic Measure HE MANAGEMENT OF demonstrated that there was no car- trends of severe hypoglycemia in the diabetes poses chal- diovascular benefit associated with United States is not known, al- lenges at all levels, tight control of glycemia (achieved though a population study from Ger- from affected indi- hemoglobin A of 6.4%, 6.4%, and many found a substantial increase 1c T viduals to society as 6.9% for ACCORD, ADVANCE, and between 1997-2000 and 2007- a whole. Microvascular complica- VADT, respectively) compared with 2010. Also, comorbid medical and tions of diabetes have been attrib- control arms (7.5%, 7.0%, and 8.4% mental health conditions that could uted to poor glycemic control since for ACCORD, ADVANCE, and affect the risk of hypoglycemia are the Joslin era. This hypothesis was VADT, respectively). In fact, highly prevalent among persons confirmed for patients with type 1 ACCORD was stopped prematurely older than 65 years. diabetes mellitus by the results of the because of increased mortality in the Another factor is also altering the Diabetes Control and Complica- intensive control group, an increase landscape: increasing recognition tions

Journal

JAMA Internal MedicineAmerican Medical Association

Published: Oct 22, 2012

References