Author Affiliations: Cardiovascular Health Research Unit, Departments of Medicine, Epidemiology, and Health Services (Dr Psaty), and Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, and Department of Biostatistics (Dr Prentice), University of Washington, Seattle; and Group Health Research Institute, Center for Health Studies, Group Health, Seattle, Washinton (Dr Psaty).
Early in the course of type 2 diabetes, mild elevations of glucose levels provoke so few symptoms that the date of disease onset may be difficult to establish, and little or no drug treatment may be necessary to minimize symptoms such as polyuria. Diabetes is nonetheless associated with the onset and progression of disabling microvascular and macrovascular disease complications. The strength of these associations with vascular disease risk is pronounced and depends on the duration of diabetes and the blood glucose level. The prevention of complications rather than the minimization of symptoms has usually served as the rationale for tight control of glucose or glycated hemoglobin.
Psaty BM, Prentice RL. Variation in Event Rates in Trials of Patients With Type 2 Diabetes. JAMA. 2009;302(15):1698-1700. doi:10.1001/jama.2009.1497