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This Journal feature begins with a case vignette that includes a therapeutic recommendation. A discussion of the clinical problem and the mechanism of benefit of this form of therapy follows. Major clinical studies, the clinical use of this therapy, and potential adverse effects are reviewed. Relevant formal guidelines, if they exist, are presented. The article ends with the authors' clinical recommendations.
A 52-year-old man with an 8-year history of type 2 diabetes mellitus visits his primary care provider for advice. His glucometer readings at home have been high despite treatment with a sulfonylurea, a thiazolidinedione, and metformin at maximal doses.
The Clinical Problem
Pathophysiology and Effect of Therapy
Clinical Evidence
Clinical Use
Adverse Effects
Areas of Uncertainty
Guidelines
Recommendations
Source Information
From the Division of Endocrinology, Diabetes, and Hypertension, Brigham and Women's Hospital, Boston.
Address reprint requests to Dr. McMahon at the Division of Endocrinology, Diabetes, and Hypertension, Brigham and Women's Hospital, 221 Longwood Ave., RFB-2, Boston, MA 02115, or at gmcmahon@partners.org.
Related Letters:
Inhaled Insulin for Diabetes Mellitus
von Kriegstein E., von Kriegstein K., Guevara C. A., Gross J. L., Henkin R. I., McMahon G. T., Arky R. A.
Extract |
Full Text |
PDF
N Engl J Med 2007;
356:2106-2108, May 17, 2007.
Correspondence
This article has been cited by other articles:
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