Mae Sheikh-Ali is an endocrinologist in Jacksonville, Florida and is affiliated with Shands Jacksonville Medical Center. She received her medical degree from Damascus University Faculty of Medicine and has been in practice for 16 years. She is one of 5 doctors at Shands Jacksonville Medical Center who specialize in Endocrinology, Diabetes & Metabolism.


Large clinical diabetes trials have demonstrated beneficial effects of lowering hemoglobin A1C on micro vascular complications. Lessons from these trials revealed that sustained intensification of medical therapy is difficult and pointed towards the progressive loss of beta cell mass over time. In the light of these results, nine new classes of drugs have been introduced over the last decade. In spite of this, the newer drugs were less potent in their efficacy to lower hemoglobin A1C than insulin therapy. Furthermore, there are yet no clinical data to demonstrate their ability to preserve beta cell function in humans. Besides that, serious adverse events were noted with the newer agents. Given all that, it important to lower hemoglobin A1C, then again the way to get there is as important learning what and when to add on therapies.