Why and When to Treat Diabetes

In spite of advances in therapy, the debilitating vascular complications of diabetes continue to occur. One of the major reasons for this is the lack of awareness among patients regarding the seriousness of diabetes and consequences of poor control. According to the Chennai Urban Rural Epidemiology Study (CURES), awareness and knowledge regarding diabetes is grossly inadequate in India.2 We need to clearly emphasise on two basic questions in Diabetes management. Why to treat and when to treat? These studies have important implications for preventing complications in diabetes. DCCT and UKPDS clearly demonstrated during ’90s that intensive control of blood glucose is important in both Type 1 and type 2 Diabetes patients. Their follow up has demonstrated equally significant findings suggesting that early treatment is what matters in controlling complications. Attempts at intensive control later in the course of the disease are clearly not going to provide the same benefit as early intensive control. It’s high time that we take note of this important public health message and start implementing early intensive control. The sooner the better. Keywords: Diabetes mellitus, intensive control, early treatment, complications.