Feature Article

Type 2 diabesity: a staging strategy for individualised, holistic care

Soji Swaraj



In this opinion piece, the importance of individualised, holistic care for people with diabetes is discussed and a strategic framework that stages patients along the insulin resistance continuum to ensure stage-specific care proposed.

Key Points

  • Individualisation of care for people with diabetes is the gold standard to ensure treatment goals are appropriately set.
  • Lapses in individualisation are manifest in lack of intensity of treatment early in the diabetes disease process and overly intensive glucose lowering strategies in the elderly.
  • A strategic framework for staging a patient along the insulin resistance continuum may trigger stage-specific prevention strategies, more holistic prioritisation of care, and alertness to prevent iatrogenic morbidity.
  • Each year, recalibration of goals and care can be triggered by reassigning the patient to one of the ‘career’ stages in the insulin resistance continuum; stage-specific medical therapeutic targets can then be reset.

    Picture credit: © Jamie Garbutt/Getty Images.