How can we implement current therapies and interventions to achieve glycemic control?

Endocrine Practice : Official Journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists
James R Gavin

Abstract

To discuss the appropriate use of oral therapies to achieve and sustain glycemic targets in patients with type 2 diabetes. The stages in the development and progression of type 2 diabetes are reviewed, and the limitations of single-drug therapy are addressed. The development of diabetes is a staged progression; affected patients show evolution through numerous stages of glucose intolerance before clinical diabetes manifests. Beta cell function continues to deteriorate until absolute failure occurs; however, other factors, such as glucose and lipid toxicities, insulin resistance in peripheral tissues, and loss of the first-phase insulin response, further impair the body's ability to regulate release of insulin in response to glucose. Traditional treatment algorithms often fail to address the progressive, multifaceted nature of type 2 diabetes, with its numerous related abnormalities. Combination therapy with orally administered agents can be used to manage glucose concentrations and other risk factors safely and effectively. The therapeutic goal in type 2 diabetes is to achieve and maintain a physiologic profile as close to normal as possible. This outcome necessitates treatment of multiple defects with use of various combinatio...Continue Reading

Citations

Nov 17, 2012·American Journal of Therapeutics·Jeffrey S Freeman, Edward S Horton
Jan 10, 2014·Diabetes & Metabolism Journal·Cesar Corzo, Patrick R Griffin

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