. In the matched cohorts, 45.1 percent of patients with specialist care versus 37.4 percent with primary care had drug intensification. To measure drug intensification, researchers compared glucose-lowering drug regimens in four-month blocks before and after the elevated A1C test. The addition of a new oral drug, a dose increase of an existing oral drug or the initiation of insulin therapy all qualified as a measure of drug intensification. Specialists increased drug use more than primary care physicians mostly by initiating insulin therapy, which may explain the lower A1C levels seen with specialist care.