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Ronald Hirsch, MD

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

As an internist with a busy office practice and a large number of patients with type 2 diabetes mellitus, I was flabbergasted to read the Commentary by Havas¹ on the lack of evidence supporting pharmacologic control of blood glucose levels and his recommendation that metformin be the sole oral agent used. Achieving a hemoglobin A_1c (HbA_1c) level below 7.0% is considered the sole measure of adequate diabetic control, and failure to achieve that mark is considered failure to adequately care for the patient. In fact, Medicare has included HbA_1c control as one of its core measures for diabetes care in the recently enacted Physician Quality Reporting Initiative.² Patients are routinely treated with multiple oral agents at a great expense, which only increases when we add injectable agents to the mix to achieve that elusive goal of an HbA_1c level less than 7.0%. They endure adverse effects . . . [Full Text of this Article]

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