[The 'Diabetes mellitus type 2' guideline (first revision) of the Dutch College of General Practitioners: response from internal medicine]

Abstract

The corrections in the revised standard 'Diabetes mellitus type 2' of the Dutch College of General Practitioners are in accordance with the recent revision of DM classification, the notion that many DM patients remain undiagnosed and the finding in the UK prospective diabetes study (UKPDS) that strict blood glucose control and hypertension control are advantageous regarding microangiopathy. However, despite the UKPDS evidence, diuretics are still recommended as first treatment for hypertension. In addition the criteria for hyperlipidaemia treatment will probably have to be revised shortly. The only severe point of criticism is the referral to a dietician and control after three months in a patient diagnosed with DM. The reviewer recommends earlier control and consideration of the height of the blood glucose level before initiating therapy.