The diabetes epidemic in the United States continues unabated,with a staggering toll in acute and chronic complications, disability,and death. The primary culprits are poor glycemic control overthe long term and other major risk factors, such as hypertension,cigarette smoking, obesity, and elevated levels of cholesterolor blood lipids. Although physicians know how to treat diabetesin individual patients, overall progress against the epidemicrequires widespread improvement in glycemic control, as underscoredby the recent finding that intensive insulin therapy reducesthe risk of cardiovascular disease among patients with type1 diabetes.1 In 2005, an estimated 20.8 million . . . [Full Text of this Article]
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Dr. Steinbrook is a national correspondent for the Journal.
An interview with Dr. Thomas Frieden, New York City Health Commissioner, can be heard at www.nejm.org.
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