Management Strategies in Type 2 Diabetes Mellitus
Summary
Management of type 2 diabetes mellitus encompasses a multi-pronged approach that integrates lifestyle modification, pharmacotherapy and risk-factor control to prevent microvascular and macrovascular complications. First-line intervention typically centres on structured dietary advice, weight management and regular moderate-intensity exercise to improve insulin sensitivity and reduce cardiovascular risk. Pharmacological regimens begin with metformin, advancing through sulfonylureas, thiazolidinediones, DPP-4 inhibitors, GLP-1 receptor agonists and SGLT2 inhibitors as glycaemic targets and comorbidities dictate. Insulin therapy remains essential for individuals with inadequate response to oral agents or marked β-cell dysfunction. Concurrent management of hypertension, dyslipidaemia and antiplatelet strategies is crucial, especially given the high burden of cardiovascular disease in this population. Recent emphasis on personalised medicine has led to stratification of treatment according to age, renal function, cardiovascular profile and risk of hypoglycaemia. Globally, integrated care models that involve multidisciplinary teams have demonstrated improvements in glycaemic control, reduction of adverse events and enhanced patient education and self-management.
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Management Strategies in Type 2 Diabetes Mellitus publication trend
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Technical terms
HbA1c: Glycated haemoglobin reflecting average blood glucose levels over approximately three months.
SGLT2 inhibitors: Agents that block renal glucose reabsorption, promoting glycosuria and lowering plasma glucose.
GLP-1 receptor agonists: Incretin-based therapies that enhance glucose-dependent insulin secretion and delay gastric emptying.
DPP-4 inhibitors: Drugs that inhibit the enzyme dipeptidyl peptidase-4, increasing levels of endogenous incretin hormones.
Insulin resistance: A diminished response of peripheral tissues to circulating insulin, leading to impaired glucose uptake.
References
- DCRM 2.0: Multispecialty practice recommendations for the management of diabetes, cardiorenal, and metabolic diseases. Metabolism (2024).
- Cardiovascular disease in type 2 diabetes mellitus: progress toward personalized management. Cardiovascular Diabetology (2022).
- Trends in Antidiabetic Drug Discovery: FDA Approved Drugs, New Drugs in Clinical Trials and Global Sales. Frontiers in Pharmacology (2022).
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