To the Editor.听
鈥擳he suggested therapeutic approach to the patients with type lib diabetes outlined in Figure 2 in the article by Lipson and Lipson1 requires comment. In each algorithm, they recommend "admission to the hospital for full evaluation to rule out infection and to give diabetes education." I suggest that this is an expensive, outmoded, and unnecessary step in the care of these patients. The vast majority of obese, maturity-onset diabetics have symptoms that can easily be controlled on an outpatient basis. Practical and straightforward clinical and laboratory evaluation can usually exclude infection if that is thought to be an issue. The hospitalized patient, however, will not eat his usual diet or exercise in his usual fashion; thus, these two factors must still be confronted at the time of discharge. Finally, every outpatient medical facility that pretends to care for diabetics must have access to a competent, preferably formalized,