Looks to me like this is a classic case of 'the treatment was a success but unfortunately the patient died'.

The ACCORD study was disturbing. Mr Mendosa's "hard question",knocked the study out. control after all does work.

Parvez ali

Over the last 25 years the heavy hitters in the field (NIH,  VA, UKs NHS) have

conducted very large scale studies which established intensive control as the

treatment which produced the best outcome for the most patients.

It's the regimen I observe.

What has not followed is the adoption of intensive control as the treatment of
choice in said institutions - The therapy, with many patients, requires close
supervision, and the same institutions have sharply reduced nursing resources
in the same interval.

Less aggressive treatment is a recipe for diabetic "complications", and anyone

who cares to know knows it - Institutional priorities are elsewhere, however.

Jack

Helen Mueller

8/16/09 2:28pm

Yes, intensive control works, but is a lot of work.  Not everyone understands the principles behind devising a personal program that works, nor can they, lacking a scientific background.  Therein enters the professional, usually a CDE.  Only where are they?  Spending more money early on allows for fewer complications and less expense later on.  But this is not the way insurance companies operate; they figure later on you become the gov't's problem, not theirs; therefore not supporting early intervention saves them money.  I have been successfully controlling my diabetes, with the help of online support communities; but there are times when I would welcome personal intervention to reprime my desire to be as well as possible.