title: Early and tight glycaemic control - the key to managing type 2 diabetes.
abstract: BACKGROUND
  The prevalence of type 2 diabetes is on the rise in Australia. A large number of patients with type 2 diabetes do not reach currently recommended glycaemic targets.
  
  
  OBJECTIVE
  This article looks at how clinical inertia contributes to suboptimal glycaemic control in patients with type 2 diabetes, describes the 'legacy' effect of early high HbA1c levels and highlights the importance of early, tight glycaemic control.
  
  
  CONCLUSIONS
  Early, tight glycaemic control in patients with type 2 diabetes has been shown to result in better outcomes in terms of micro- and macrovascular disease and mortality even if control is relaxed later in the course of the disease. Clinical inertia is one of the contributing factors that prevent patients from reaching glycaemic targets. A proactive approach to treating type 2 diabetes is recommended: therapy should be individualised with early consideration of combination therapy and ongoing reinforcement of lifestyle modification messages. In newly diagnosed patients, the goal should be to achieve an HbA1c of.
authors.affiliation: g.deed@uqconnect.net
authors.forename: Gary
authors.initials: G
authors.lastname: Deed
authors.forename: John
authors.initials: J
authors.lastname: Barlow
authors.forename: Ivan
authors.initials: I
authors.lastname: Kuo
mesh_terms: D001315:Australia; D001786:Blood Glucose / Q000187:drug effects*; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy*; D018450:Disease Progression; D006442:Glycated Hemoglobin; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D008687:Metformin / Q000627:therapeutic use*; D010818:Practice Patterns, Physicians'
chemical_list: D001786:Blood Glucose; D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents; D008687:Metformin