Many Patients Unable to Manage Disease

Despite many advances in treating diabetes, the majorityof adults with the disease have not reached the appropriateHbA_1C goal. Reporting in the American Journal ofManaged Care (April 2005), Kaiser Permanente conductedthe first head-to-head analysis of the use of all currentavailable treatments for diabetes. The study involved 4775members of Kaiser Permanente Northern CaliforniaGroup.

The study's findings showed that >80% of badly controlledadults with type 2 diabetes who started new antidiabetictherapies did not achieve recommended glycemictargets (HbA_1C ≤7%) within 1 year. The researchers suggestedthe need for more aggressive and earlier intensificationof established therapies; less waiting time withquick progression from single therapy to combination therapywith or without insulin; and further investigation ofways to incorporate behavioral change.