Matthew Mintz: “I would argue that one of the reasons you might actually cause harm in intensively trying to lower sugar, is when you need insulin to get to that goal. This suggest (contrary to the ADA guidelines) that targeting to an A1c of less than 7.0% should be done with multiple medications, and not with insulin. In fact, it might be better to reserve insulin for those patients with an A1c of more than 8%, despite multiple oral agents (again, contrary to ADA guidelines).”
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