Managing diabetes for improved health and economic outcomes.

The contribution of postprandial glucose to diabetes progression and diabetes-related complications lends a new perspective to diabetes management. It has been long understood that tightly controlled glucose levels improve diabetes outcomes. Clinical studies and simulated models have estimated the impact of improved glycemic control on the economic outcomes of this disease, reporting that these cost benefits can be both short term and long term. The new economics of diabetes management emphasizes improved management through strategies such as better adherence to frequency of monitoring guidelines. The health and economic benefits have been demonstrated incrementally with improved glycemic status. Of additional importance to realizing economic benefits is the use of therapies that maintain lower glucose levels while minimizing side effects, hypoglycemic episodes, and long-term diabetes-related complications. Fast-acting insulins and the newer classes of insulin secretagogues, which target postprandial glucose, may pose distinct therapeutic advantages in this regard.