Earlier intervention in type 2 diabetes: The case for achieving early and sustained glycaemic control

Authors

  • C. J. Bailey,

    Corresponding author
    1. Aston University,1Birmingham, UK, University of Pisa,2Pisa, Italy, The Archimedes Project,3Oakland, CA, USA, Mount Sinai Hospital,4University of Toronto, Toronto, Canada
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  • 1 S. Del Prato,

    1. Aston University,1Birmingham, UK, University of Pisa,2Pisa, Italy, The Archimedes Project,3Oakland, CA, USA, Mount Sinai Hospital,4University of Toronto, Toronto, Canada
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  • 2 D. Eddy,

    1. Aston University,1Birmingham, UK, University of Pisa,2Pisa, Italy, The Archimedes Project,3Oakland, CA, USA, Mount Sinai Hospital,4University of Toronto, Toronto, Canada
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  • and 3 B. Zinman 4

    1. Aston University,1Birmingham, UK, University of Pisa,2Pisa, Italy, The Archimedes Project,3Oakland, CA, USA, Mount Sinai Hospital,4University of Toronto, Toronto, Canada
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  • *

    Global Partnership for Effective Diabetes Management Members: George Alberti, University of Newcastle upon Tyne, Newcastle upon Tyne, UK; Pablo Aschner, Javeriana University School of Medicine, Bogota, Colombia; Cliff Bailey, Aston University, Birmingham, UK; Lawrence Blonde, Oschner Clinic Foundation, New Orleans, LA, USA; Stefano Del Prato, University of Pisa, Pisa, Italy (Chair); Anne-Marie Felton, Federation of European Nurses in Diabetes, London, UK; Barry Goldstein, Jefferson Medical College of Thomas Jefferson University, PA, USA; Ramon Gomis, Hospital Clinic, Barcelona, Spain; Edward Horton, Joslin Diabetes Center, Boston, MA, USA; James LaSalle, Medical Arts Research Collaborative, Excelsior Springs, MO, USA; Hong-Kyu Lee, Seoul National University, College of Medicine, Seoul, Korea; Lawrence Leiter, St. Michael's Hospital, Toronto, ON, Canada; Stephan Matthaei, Diabetes-Zentrum Quakenbruck, Quakenbruck, Germany; Marg McGill, Diabetes Centre, Royal Prince Alfred Hospital, Sydney, Australia; Neil Munro, Primary Care Diabetes Europe, Surrey, UK; Richard Nesto, Lahey Clinic, Burlington, MA, USA; Paul Zimmet, International Diabetes Institute, Caulfield, Australia; and Bernard Zinman, Mount Sinai Hospital, University of Toronto, Toronto, Canada.

Prof. Clifford Bailey, PhD, School Of Life and Health Sciences, Aston University, Aston Triangle, Birmingham B4 7ET, UK
Tel.: + 44 121 204 3898
Fax: + 44 121 204 3892
Email: c.j.bailey@aston.ac.uk

Summary

In type 2 diabetes, the onset and progression of complications is significantly delayed by improving glycaemic control. However, the proportion of patients reaching and sustaining guideline recommendations for glycaemic targets remains unacceptably low. Recent clinical trials and predictive physiologically based mathematical simulations (Archimedes model) indicate that benefits can be enhanced with earlier intervention and timely achievement of glycaemic targets. This article reviews the evidence for early intervention, showing that intensive approaches, including earlier introduction of combination therapy, allow more patients to achieve glycaemic targets and hence reduce complications and delay disease progression.

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