William H. Herman, MD, MPH

In this segment, William Herman, MD, MPH, analyzes Dr Huckfeldt's presentation on glycemic targeting from a health service and clinical research perspective.

Over 10 years, among adherent participants, lifestyle intervention and metformin were effective and cost-effective for diabetes prevention compared with placebo.

Processes and outcomes of diabetes care improved substantially over 6 years in a managed care health plan with a comprehensive diabetes disease management program.

Perception of reimbursement was associated with electrocardiography but not with other common outpatient procedures. Future research should investigate how associations change with perceived reimbursement amount.

This study showed that complications add significantly to the cost of medical care when hyperglycemia levels were below the threshold for diabetes, and impaired glucose tolerance independently contributed to costs.