Our fondness for excessive treating is resulting in excessive treatment of patients. In this article, we talk about how this excessive testing is harming our patients with diabetes. When I began my medical training in 1980, I commonly encountered patients whose bodies were ravaged by end stage complications of diabetes. These patients often had marked visual impairment, debilitating neuropathy, myopathies, and diabetes related renal insufficiency, well before age 65 years.
I still occasionally see such individuals, but they are rare, and tend to come from the 10-15% of patients who still have poor glycemic control. Improvement in diabetes care is a medical success story, but increasing evidence suggests that overly aggressive treatment is an under-appreciated problem. In a linked study, McCoy and colleagues report that a cohort of patients with excellent glycemic control of their type…
