Clinical evidence: Glycaemic control in diabetes

This review is one of over 60 chapters included in the first issue of Clinical Evidence , a new information resource for clinicians available from 28 June 1999. The compendium will be updated and expanded every six months. Future issues of Clinical Evidence will summarise the relevant results of the UK prospective diabetes study. #### Key messages www.evidence.org Subscription details at end of article Definition: Diabetes mellitus is a group of metabolic diseases characterised by hyperglycaemia (fasting plasma glucose ≥7.0 mmol/l, or two hour post 75g oral glucose load plasma glucose ≥11.1 mmol/l, on two or more occasions). Intensive treatment is designed to achieve blood glucose values as close to the non-diabetic range as possible. The essential components of such treatment are education, counselling, monitoring, self management, and pharmacological treatment with insulin or oral antidiabetic agents, to achieve specific glycaemic goals. Incidence/prevalence: Diabetes is diagnosed in around 5% of adults aged 20 years or over in the United States.1 A further 2.7% have undiagnosed diabetes on the basis of fasting glucose. The prevalence is similar in men and women, but diabetes is more common in many ethnic groups. The prevalence in people aged 40-74 has increased over the past decade. Aetiology: Diabetes results from deficient insulin secretion, decreased insulin action, or both. Many processes can be involved, ranging from autoimmune destruction of the β cells of the …