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Introduction

Diabetes is a chronic disease, that afflicts approximately 26.9% of U.S. residents aged 65 years and older.  1.9 million are diagnosed with diabetes every year, and an additional 7.0 million go undiagnosed and untreated (Centers for Disease Control, 2011).  More than 1 in 5 health care dollars in the U.S. goes to the care of people with diagnosed diabetes, costing $245 billion dollars annually (American Diabetes Association, 2012).

Appropriate medication management targeting glycemic control, hypertension, and lipid management is important for reducing morbidity and mortality, and improving long-term quality of life for patients diagnosed with type 2 diabetes mellitus (T2DM).  Lifestyle changes such as nutrition therapy, weight loss, increased exercise, and appropriate education and self-management strategies are pivotal to improved outcomes.  Inadequate access to care for chronic disease management as well as the cost of medication can contribute to poor control of T2DM and associated cardiovascular risk factors.

In the current iteration of this guideline, we have focused on the importance of appropriate identification and diagnosis, followed by effective approaches to lifestyle management and pharmacologic therapy.  Due to the high percentage of the U.S. population that is diagnosed with diabetes and the effect diabetes has on other comorbidities, appropriate management will improve the patient's experience of care and the health of the population, reducing office visits, emergency department visits, cardiovascular complications.  Other related conditions will in turn reduce the total cost of care.