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REVIEW ARTICLE
Year : 2014  |  Volume : 18  |  Issue : 2  |  Page : 166-174

Treat-to-target trials in diabetes


1 Department of Endocrinology, Indraprastha Apollo Hospital, Delhi, India
2 Department of Endocrinology, Care Hospital, Hyderabad, India
3 Department of Endocrinology, Osmania Medical College and Hospital, Hyderabad, India
4 Department of Endocrinology, Providence Endocrine and Diabetes Specialty Centre, Trivandrum, India
5 Department of Diabetology, Nightingale Hospital, Kolkata, India
6 Department of Endocrinology, Dr. SK Sharma's Diabetes Thyroid and Endocrine Centre, Jaipur, Rajasthan, India

Correspondence Address:
Subhash K Wangnoo
Senior Consultant Endocrinologist, Endocrinology, Indraprastha Apollo Hospital, Delhi Mathura Road, New Delhi - 110 076
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/2230-8210.129106

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Treat-to-target is a therapeutic concept that considers well defined and specific physiologic targets as aims in controlling the pathophysiology of the disease. It has been widely used in diseases that pathophysiology includes, chronic metabolic and physiological disturbances, namely rheumatic conditions, vascular medicine and diabetes. In diabetes, the availability of "gold-standard" quantitative measures like fasting plasma glucose and glycated hemoglobin make the application of treat-to-target trials especially pertinent. Treatment modalities which have used single therapeutic agents or combinations or in combination with a variety of titration algorithms and implementation protocols have broadened our understanding of diabetes management with specific reference to insulin initiation and maintenance. Treat-to-target trials have been used to investigate a wide variety of questions including efficacy, safety, effect of treatment on comorbidities and patient satisfaction, ideal mechanisms to implement insulin initiation etc. A more generalized acceptance and implementation of treat-to-target trials may finally revolutionize diabetes management by combining aspects of individual care with standard treatment protocols.


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