Fineman MS, Baron AD: Effects of exenatide (exendin-4) on glycemic control and weight over 30 weeks in metformintreated patients with type 2 diabetes. Diabetes Care 28:1092-1100, 2005 2. Buse JB, Henry RR, Han J, Kim DD, Fineman MS, Baron AD: Effects of exenatide (exendin-4) on glycemic control over 30 weeks in sulfonylurea-treated patients with type 2 diabetes. Diabetes Care 27:
This study confirms that one basal rate is adequate for the majority of subjects with type 2 diabetes. The mathematical proportionality between dosing factors closely agrees with those obtained in CGM-titrated pump-treated type 1 diabetes but differs from those derived from clinical studies in which insulin titration was based on infrequent self-monitored plasma glucose testing and while on an unstructured diet.
The purpose of this article is to describe a pilot program using centralized diabetes specialist services to guide primary care treatment of diabetes. The program demonstrated the feasibility of disseminating diabetes treatment guidance from a centralized diabetologist clinic. Across all participating sites, approximately 50% of patients achieved HbA1c values of 6.9% or lower. Approximately 80% of all patients participating achieved low-density lipoprotein cholesterol values of 129 mg/dL or lower, and 50% had systolic blood pressure values of 129 mm Hg or lower. Results of the program are promising and deserve further study. Hallmarks of the program include dissemination of diabetes care through midlevel practitioners in primary care offices, using standardized algorithms, and computer-assisted guidance of therapy.
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