Intensive vs. Individualized Type 2 Diabetes Control

Intensive diabetes control can lead to severe hypoglycemia or excess early mortality (NEJM JW Gen Med Jul 1 2008 and N Engl J Med 2008; 358:2545). Individualized treatment for patients with type 2 diabetes changes glycemic control from universally set, intensive management goals (e.g., glycosylated hemoglobin [HbA_1c] <7%) to individualized glycemic goals based on factors such as age, life expectancy, comorbidities, complication history, and hypoglycemia risk). Several years ago, the American Diabetes Association endorsed this “patient-centered approach” (NEJM JW Gen Med Aug 15 2012 and Diabetes Care 2012; 35:1364).

In this economic analysis of diabetes management, researchers used a U.S. database of type 2 diabetes patients to demonstrate a …