• P Valensi.
• Presse Med. 1997 Oct 11; 26 (30): 143614381436-8.

AbstractIn diabetic patients, blood glucose should be controlled to a level which prevents acute metabolic complications, forestalls the development of micro and macroangiopathic complications and remains compatible with good quality of life. Recent interventional trials in both insulin-dependent and non-insulin-dependent patients have helped identify this target glucose level. Maintaining HbA1c between 7 and 7.5% appears to be a realistic objective with minimum risk of severe hypoglycemia. This goal, which may be difficult to reach in certain patients, can only be achieved through the co-ordinated efforts of patients and health care providers. The ideal system includes patient education, renewed training for general practitioners who care for most of the non-insulin-dependent as well as a large number of insulin-dependent diabetic patients in France, close follow-up with regular consultations (calling upon specialists when therapeutic adaptations are required) and an organized system of nursing care by specially trained caregivers. The extra cost of this combined organization is to be balanced against expenditures for complications of diabetes.

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