Diabetes is now considered a major chronic disease. Scientific understanding of the causes and mechanisms of diabetes has advanced greatly in the last decade. Good epidemiologic data now define the high prevalence of diabetes and the serious morbidity and mortality that result from it. Several new drug preparations have increased our ability to treat this disorder. The immense financial costs of diabetes have been documented and business methods applied to curtail them.

Previously disjointed efforts to deal with diabetes deserve a new strategy and set of tactics. The obvious strategy is to consider the problems presented by diabetes at all stages of its natural history, including all of its complications and deploying all available treatments. Specific tactics follow from this concept. Aspects of the natural history of diabetes and its complications have been reviewed in a recent issue of Clinics in Endocrinology and Metabolism,<sup>37 Krolewski A.S., Warram J.H., Freire M.B.S. Epidemiology of late diabetic complications: A basis for the development and evaluation of preventive programs Endocrinol Metab Clin North Am 1996 ;  25 : 217-242  [cross-ref]

Cliquez ici pour aller à la section Références</sup> and current methods for treating diabetes are described in detail elsewhere in this issue. This article outlines strategy and tactics for deploying these methods in patients with type II diabetes, the dominant form of this condition. The focus is on glycemic control. Other important risk factors for vascular disease that often coexist with diabetes are beyond the scope of this review.