Importance of control in type II diabetes mellitus.
OBJECTIVE
To determine the effect of maintenance of control of type II diabetes mellitus on the occurrence of complications.


METHODS
Various published studies of populations of patients with diabetes are reviewed, and their results in terms of diabetic control and development of retinopathy, nephropathy, neuropathy, and macrovascular disease are summarized.


RESULTS
Maintenance of near-euglycemia reduced the risk of worsening diabetic retinopathy; proliferative retinopathy developed in few patients with well-controlled diabetes. Similarly, worsening proteinuria was more common in patients with fair and poor control of diabetes in comparison with those who were able to maintain good control of diabetes. Furthermore, patients with poor diabetic control experienced a faster deterioration of peripheral neurologic function than did the patients with well-controlled diabetes. In five prospective studies of a total of 2,471 patients with type II diabetes, stricter control of diabetes was associated with fewer cardiovascular events and deaths.


CONCLUSIONS
Overwhelming evidence from published prospective studies indicates that the complications often associated with type II diabetes can be minimized or delayed by maintaining good control of the disease.
Davidson
M B
MB
Department of Diabetes, Endocrinology & Metabolism, City of Hope National Medical Center, Duarte, California 91010, USA.