title: Loss of confidence in diabetes management.
abstract: Using current treatment approaches, many patients with type 2 diabetes do not achieve glycemic goals--and do experience macrovascular complications that contribute to morbidity and mortality. It's time to consider other options.
  
  
  CONCLUSIONS
  Aggressive therapeutic interventions aimed at insulin resistance and cell dysfunction may alter outcomes. Managed care organizations may need to modify the way they look at diabetes and should consider changing their focus from drug costs to wellness. Value-based insurance design may provide opportunities to optimize diabetes management, resulting in improved outcomes for patients and economic benefits for managed care organizations.
authors.affiliation: PRS Healthcare Consulting, Larkspur, California, USA.
authors.forename: Patricia R
authors.initials: PR
authors.lastname: Salber
authors.forename: William
authors.initials: W
authors.lastname: Bestermann
authors.forename: Stanley
authors.initials: S
authors.lastname: Schwartz
authors.forename: Albert
authors.initials: A
authors.lastname: Marchetti
mesh_terms: D000465:Algorithms; D001786:Blood Glucose / Q000032:analysis / Q000187:drug effects; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy / Q000503:physiopathology / Q000517:prevention & control*; D019468:Disease Management; D006293:Health Promotion; D006801:Humans; D007004:Hypoglycemic Agents / Q000145:classification / Q000627:therapeutic use; D007333:Insulin Resistance; D050417:Insulin-Secreting Cells / Q000473:pathology; D008329:Managed Care Programs / Q000191:economics / Q000592:standards; D018802:Patient-Centered Care; D017410:Practice Guidelines as Topic; D040242:Risk Reduction Behavior; D014481:United States; D014837:Voluntary Health Agencies
chemical_list: D001786:Blood Glucose; D007004:Hypoglycemic Agents