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May 20, 1998

Insulin Treatment for Type 2 Diabetes

Author Affiliations

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

JAMA. 1998;279(19):1523-1526. doi:10-1001/pubs.JAMA-ISSN-0098-7484-279-19-jbk0520

To the Editor.—Dr Hayward and colleagues1 refer to the relationship between HbA1c and microvascular disease demonstrated by the Diabetes Control and Complications Trial Research Group as the basis for exploring effective strategies for improving glycemic control in individuals with type 2 diabetes.

One of the ways insulin achieves glycemic control is by facilitating the formation of triglyceride as evidenced by weight gain among the mostly lean, younger, insulin-dependent diabetes mellitus population of the Diabetes Control and Complications Trial.2 Even if we achieve a lower incidence of microvascular disease by glycemic control through therapy that includes insulin, should we not be concerned about the association of macrovascular disease with higher lipid levels in the mostly obese, older type 2 diabetics?

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