Medicine Grand Rounds, John B. Buse “Type 2 Diabetes Care: Struggle, Progress and the Future”

Type 2 diabetes is a major and growing contributor to poor health outcomes globally. Clinical science has conclusively demonstrated that glycemic control reduces the risk of microvascular complications – eye, kidney and nerve disease. For cardiovascular disease, blood pressure and lipid management, smoking cessation and antiplatelet therapies are effective in reducing risk. However, great controversy regarding the utility of glycemic management to reduce cardiovascular disease has persisted. Further, treatment with insulin – the mainstay of late diabetes care – has been associated with increasing concerns about hypoglycemia and its impact on health outcomes and quality of care. Dr. Buse will review major trials published over the last 18 months that have revolutionized the landscape of type 2 diabetes care and suggest a new path forward to reduce the morbidity and mortality associated with the diabetes epidemic.

Dr. Buse’s practice combines clinical care, research and education. He has received international recognition for innovative efforts at prevention of type 1 diabetes, type 2 diabetes and their complications. He practices patient-centered care focusing on developing treatment programs in collaboration with patients that meet their needs and expectations. He works with teams of investigators in diabetes clinical trials, comparative effectiveness research and translation of basic science research towards clinical application. Current projects focus in novel treatments including development of glucose-responsive insulin, cardiovascular safety and efficacy of diabetes drugs and developing the evidence-base for treatment guidelines of the future in diabetes care.

Dr. Buse is Chief of the Division of Endocrinology, Director of the NC Translational and Clinical Sciences Institute, Director of the Diabetes Center and is the Executive Associate Dean for Clinical Research at the University of North Carolina School of Medicine. He has clinical practices at the UNC Highgate Specialty Center in Durham, NC and the Salem Center in Winston-Salem, NC. He enjoys lecturing about diabetes.