Diabetes is treated first and foremost with diet and exercise. Early treatment consists of frequent glucose monitoring and hemoglobin A1C monitoring every three months. Oral therapies are the preferred methods of treatment, but we are careful to use insulin early if needed as to prevent microvascular damage. More than 95% of diabetics can be treated in our office setting, and the rest are treated in conjunction with an endocrinologist. Because diabetes is considered a major risk factor for cardiovascular disease, our diabetics are treated more aggressively and to tighter control of their blood pressures and cholesterol.