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Diabetes Mellitus Type 2

Discussion

Therapeutic Goals: More Than Glucose!

The major goals are to control the diabetes with minimal impact on the patient's lifestyle and to prevent short-term and long-term complications of the disease.

The landmark Diabetes Control and Complications Trial (DCCT) and the UK Prospective Diabetes Study (UKPDS) showed conclusively that good glucose control can delay or prevent the microvascular complications, retinopathy and renal failure, and neuropathy. The UKPDS also proved that to decrease cardiovascular disease, the major killer in diabetes, it is necessary to control blood pressure as well. Diabetic patients have the same risk for a myocardial infarction as a non-diabetic patient who already has had one. Therefore the lipid targets are the same.

Glucose control: HbA1c < 6.5% (nl. 4-6%)
The target range for blood glucose tests is between 80 - 120 mg/dL before meals and below 140 mg/dL two hours after meals.

BP control: < 130/80

Lipid control:

Total cholesterol < 200, LDL <= 100

Triglycerides < 200, HDL > 35 (men), > 45 (women)