PMID- 21806772
OWN - NLM
STAT- MEDLINE
DCOM- 20120119
LR  - 20211217
IS  - 1751-7176 (Electronic)
IS  - 1524-6175 (Print)
IS  - 1524-6175 (Linking)
VI  - 13
IP  - 8
DP  - 2011 Aug
TI  - Overcoming obstacles in risk factor management in type 2 diabetes mellitus.
PG  - 613-20
LID - 10.1111/j.1751-7176.2011.00490.x [doi]
AB  - Type 2 diabetes mellitus (T2DM) is characterized by progressively worsening 
      hyperglycemia that leads to microvascular and macrovascular complications. 
      Optimal management of T2DM aims to simultaneously control hyperglycemia, 
      hypertension, and dyslipidemia to reduce the overall risk. However, a large 
      proportion of patients in clinical practice do not reach treatment targets. Some 
      of the obstacles to achieving treatment targets include high medication costs, 
      costs associated with health insurance, poor patient adherence to medication, 
      patient fear of potential adverse effects, improper patient education, and 
      failure by health care providers to appropriately initiate or intensify therapy 
      (clinical inertia). Possible causes of clinical inertia include the influence 
      exerted on physicians by reluctant patients and the influence of media-driven 
      attention and the negative spin of clinical trial results on physicians' 
      prescribing behavior and on patients' attitudes towards treatment. This negative 
      publicity can be disproportionate to the overall body of scientific evidence and 
      may, therefore, prove to be unfounded in the long-term. There is clear evidence 
      of the benefits of the effective management of T2DM to achieve goals. Overcoming 
      the obstacles to achieving treatment targets may include use of strategies such 
      as early intensive treatment and combination therapy with drugs with 
      complementary mechanisms of action.
CI  - (c) 2011 Wiley Periodicals, Inc.
FAU - Handelsman, Yehuda
AU  - Handelsman Y
AD  - Metabolic Institute of America, Tarzana, CA 91356, USA. yhandelsman@pacbell.net
FAU - Jellinger, Paul S
AU  - Jellinger PS
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PT  - Review
DEP - 20110714
PL  - United States
TA  - J Clin Hypertens (Greenwich)
JT  - Journal of clinical hypertension (Greenwich, Conn.)
JID - 100888554
SB  - IM
MH  - Diabetes Mellitus, Type 2/*complications/*therapy
MH  - *Disease Management
MH  - Dyslipidemias/epidemiology
MH  - Humans
MH  - Hyperglycemia/epidemiology
MH  - Hypertension/epidemiology
MH  - Risk Factors
MH  - Treatment Failure
PMC - PMC8108978
EDAT- 2011/08/03 06:00
MHDA- 2012/01/20 06:00
PMCR- 2011/07/14
CRDT- 2011/08/03 06:00
PHST- 2011/08/03 06:00 [entrez]
PHST- 2011/08/03 06:00 [pubmed]
PHST- 2012/01/20 06:00 [medline]
PHST- 2011/07/14 00:00 [pmc-release]
AID - JCH490 [pii]
AID - 10.1111/j.1751-7176.2011.00490.x [doi]
PST - ppublish
SO  - J Clin Hypertens (Greenwich). 2011 Aug;13(8):613-20. doi: 
      10.1111/j.1751-7176.2011.00490.x. Epub 2011 Jul 14.