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Difficult Diabetes

BMJ 2001; 322 doi: (Published 09 June 2001) Cite this as: BMJ 2001;322:1432
  1. Kevin Baynes, clinical lecturer in diabetes and endocrinology
  1. St Thomas's Hospital, London

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    Eds Geoff Gill, John Pickup, Gareth Williams

    Blackwell Science, £59.50, pp 320

    ISBN 0 632 05324 0

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    Diabetes has scandalised me, scandalised and seduced in equal measure. The scandals have been the past lack of clinical trials with sensible outcome measures and the discrimination felt by people with diabetes from insurers, the Driver and Vehicle Licensing Authority, and employers. The seductions have been the nefarious clinical manifestations of diabetes and the complexity of understanding its pathophysiologies.

    Since the publication of the Diabetes Control and Complication Trial and the United Kingdom Prospective Diabetes Study, we all feel more justified in chasing the holy grail of a low HbA1c—some patients more assiduously and more obsessively than their doctors. Can we do this more effectively and …

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