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May 20, 1998

Insulin Treatment for Type 2 Diabetes

Author Affiliations

Margaret A.WinkerMD, Senior EditorIndividualAuthorPhil B.FontanarosaMD, Senior EditorIndividualAuthor


Copyright 1998 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Restrictions Apply to Government Use.1998

JAMA. 1998;279(19):1523-1526. doi:10.1001/jama.279.19.1523

To the Editor.—We are intrigued by the data of Dr Hayward and colleagues1on the treatment of type 2 diabetes by generalists, but we question their conclusions. They found mean hemoglobin A1c(HbA1c) levels in all patients to be 8%, better than in earlier studies. Sixteen percent of patients not taking insulin initially began insulin and had 0.9% lower HbA1c levels a year later. Despite this improvement, 60% of these patients failed to reach an 8% (0.08) HbA1clevel that indicated acceptable control. Short-term costs of starting insulin included a few more visits and tests and a 4-fold increase in glucose self-testing.

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