Improving Diabetes Outcomes: Beyond Glucocentricity
- Tom Elasy, MD, MPH, Editor-in-Chief
Alteration in glucose homeostasis is the sine qua non of diabetes. Independent of the type of diabetes, all individuals with diabetes share some perturbation in the ability to maintain glucose within a specified range. Not surprisingly, glucose regulation has been a key focus in understanding disease pathogenesis and progression as well as the target of diabetes interventional trials. Indeed, the seminal clinical trials in diabetes during the past 15 years (the Diabetes Control and Complications Trial, the U.K. Prospective Diabetes Study, and the Diabetes Prevention Program) have all given core attention to glucose regulation, either as treatment or prevention. All three trials have demonstrated the wisdom and benefit of an approach that addresses glucose control. Yet a focus on glucose alone is an incomplete approach to the care of individuals with diabetes. The profound impact of improving other disturbances in diabetes has become clear during the past 10-15 …
