Intended for healthcare professionals


Tight control of blood glucose in long standing type 2 diabetes

BMJ 2009; 338 doi: (Published 06 March 2009) Cite this as: BMJ 2009;338:b800

Time for Patient-driven goals?

I cannot add substantially to the discussion but would like to
highlight a few points already well made.

1. To Dr. Hall: It would seem refreshing and appropriate if those
who pushed an agenda of "lower is better" would come out in a voice with
equal or greater volume humbly admitting that a mistake has been made.
This would build the trust of those patients we serve.

2. To Dr. Morrison: Indeed! We should find a way to put the
patient's values and wishes uppermost in our care...which brings me to
point # 3...

3. To Dr. Gude: As long as there are payers, we are likely going to
have our performance measured. The key may be in developing metrics that
are meaningful to patients. This would be more challenging...but worth
the effort!

For example:

Percentage of patients who have had a discussion with their providers
about glycemic control.

Percentage of patients who are achieving the target THEY have chosen.

Competing interests:
None declared

Competing interests: No competing interests

01 May 2009
Mark E McConnell
Internal Medicine
VAMC 54601