Intended for healthcare professionals

Editorials

Tight control of blood glucose in long standing type 2 diabetes

BMJ 2009; 338 doi: https://doi.org/10.1136/bmj.b800 (Published 06 March 2009) Cite this as: BMJ 2009;338:b800

Is hyperinsulinemia the culprit for worse results orf aggressive glucose control?

The paradox of aggressive glucose lowering poses a major health care
dilemma. From a non-expert viewpoint, it seems that the present evidence
rasied against insulin or insulin-secratagogues use. Metformin is not a
insulin secretion enhancer. We kept on searching for evidence that
insulin/insulin secretagogue benifited the patients and found none.
However, raised HbA1c did correlate with CV problems. Is it possible that
insulin the culprit for enhancing atheroscleorosis? Some experimental
evidence did suggest so. Maybe we should switch another lane.

Competing interests:
None declared

Competing interests: No competing interests

23 April 2009
Wenyi Yang
surgeon
Taiwan Taichung Dali Jenai hospital