Newer Treatment Strategies for the Management of Type 2 Diabetes Mellitus

2004 ◽  
Vol 17 (1) ◽  
pp. 49-54 ◽  
Author(s):  
Susan Cornell ◽  
Amber Briggs
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Glycosylated Hemoglobin ◽  
Treatment Options ◽  
Treatment Strategies ◽  
Treatment Goals ◽  
Microvascular And Macrovascular Complications

Type 2 diabetes mellitus is a multiorgan, metabolic disease associated with multiple microvascular and macrovascular complications. The incidence of type 2 diabetes is growing at an alarming rate. Achieving and maintaining near-normal blood glucose and glycosylated hemoglobin levels (A1C) are of the utmost importance. Existing treatment options for managing type 2 diabetes, which have primarily included sulfonylureas and biguanides, are insufficient at achieving these treatment goals alone, particularly if used long term. The need to explore newer and better treatment options that provide longer lasting glucose control and at the same time focus on targeting cardiovascular risk factors to minimize and prevent the serious complications associated with this multifaceted disease becomes quite obvious.

scholarly journals Optimizing treatment goals for long-term health outcomes among patients with type 2 diabetes mellitus

2021 ◽  
Vol 9 (1) ◽  
pp. e002396
Author(s):  
Qian Shi ◽  
Yilu Lin ◽  
Vivian A Fonseca ◽  
Lizheng Shi
Keyword(s):  
Diabetes Mellitus ◽  
Blood Pressure ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Health Outcomes ◽  
Treatment Strategies ◽  
Optimal Treatment ◽  
Treatment Goals ◽  
Macrovascular Complication

IntroductionConsiderable confusions on treatment target have resulted from recent changes in guidelines. Evidence in medical guidelines came from clinical trials with highly selected patients, whereas treatment goals may differ in some subgroups. This study aimed to assess optimal treatment goals (A1C, blood pressure, low-density lipoprotein cholesterol (LDL-C)) for patients with type 2 diabetes mellitus (T2DM), which lead to optimal health outcomes by different treatment strategies.Research design and methodsA retrospective longitudinal study was conducted for veterans with T2DM by using US Veterans Affairs Administrative Database (2005−2015). Medical records were prepared for repeated evaluation performed at 6-month intervals and multivariate longitudinal regression was used to estimate the risk of microvascular and macrovascular complication events. Second-degree polynomial and splines were applied to identify the optimal goals in their associations with lowest risk of clinical outcomes, controlling for demographic characteristics, medical history, and medications.ResultsA total of 124 651 patients with T2DM were selected, with mean of 6.72 follow-up years. In the general population, to achieve the lowest risk of microvascular and macrovascular complication, the optimal goals were A1C=6.81%, LDL-C=109.10 mg/dL; and A1C=6.76%, LDL-C=111.65 mg/dL, systolic blood pressure (SBP)=130.60 mmHg, respectively. The optimal goals differed between age and racial subgroups. Lower SBP for younger patients and lower LDL-C for black patients were associated with better health outcomes.ConclusionsOptimal treatment goals were identified and multi-faceted treatment strategies targeting hyperglycemia and hyperlipidemia and hypertension may improve health outcome in veterans with T2DM. In addition to guidelines’ recommended goals, health systems may examine their own large diverse patients with T2DM for better quality of care.

scholarly journals Quantifying Remission Probability in Type 2 Diabetes Mellitus

2021 ◽  
Vol 11 (4) ◽  
pp. 850-859
Author(s):  
Sanjay Kalra ◽  
Ganapathi Bantwal ◽  
Nitin Kapoor ◽  
Rakesh Sahay ◽  
Saptarshi Bhattacharya ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Diabetes Management ◽  
Treatment Options ◽  
Nutrition Therapy ◽  
Progressive Disorder ◽  
Medical Nutrition

Type 2 diabetes mellitus (T2DM) is a chronic progressive disorder and is associated with significant morbidity and mortality. The concept of T2DM remission and the reversal of diabetic parameters to normal levels has been gaining momentum over the past years. T2DM remission is increasingly being recognized by various global guidelines. Multiple models have been developed and validated for quantifying the extent of remission achieved. Based on favorable clinical evidence, T2DM remission can be considered as the therapeutic goal in diabetes management and, in select cases, as an alternative to expensive treatment options, which can be burdensome as T2DM progresses. This narrative review discusses the available strategies, such as lifestyle interventions, physical activity, bariatric surgery, medical nutrition therapy, and non-insulin glucose-lowering medications, for achieving T2DM remission. Although the concept of T2DM remission has emerged as a real-world option, effective implementation in routine clinical practice may not be feasible until long-term studies prove the efficacy of different approaches in this regard.

scholarly journals RISK FACTORS OF TYPE 2 DIABETES MELLITUS DURATION AND NON-COMPLIANCE WITH MEDICATION TO POOR GLYCEMIC STATUS

2020 ◽  
Vol 8 (3) ◽  
pp. 256
Author(s):  
Marisa Gita Putri ◽  
K. Heri Nugroho HS ◽  
Mateus Sakundarno Adi ◽  
Suhartono Suhartono ◽  
Bagoes Widjanarko
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Glycosylated Hemoglobin ◽  
Exclusion Criterion ◽  
Glycemic Status ◽  
Type 2 Dm

Background: Type 2 diabetes mellitus is a chronic disease that is still a global health problem. Uncontrolled diabetes mellitus (DM) can result in poor glycemic status, with factors that affect patients including long-term DM and medication compliance. Purpose: This study aimed to determine the risk factors of long-term DM and non-compliance with medication on the poor glycemic control status of patients with type 2 DM. Methods: This type of research used observational analysis with a case–control design. Samples were taken from patients with type 2 DM, with 40 cases and 40 controls. The criteria for sample inclusion were that the patients had a glycosylated hemoglobin level check, were willing to be research respondents, and could communicate well. The exclusion criterion was patients experiencing a drastic decline in health status during the study. The sampling technique used was consecutive sampling. This research was conducted at the Panti Wilasa Citarum Hospital in Semarang City from July to September 2019. The relationship and the risk of long-term DM and adherence to taking medication with glycemic status were tested using the chi-square test. Results: This study showed that a duration of DM >5 years (p = 0.01; Odss Ratio (OR) = 3.46; 95% confidence interval [CI] = 1.37 < OR < 8.69) and non-compliance with taking medication (p = 0.02; OR = 3.15; 95% CI = 1.25 < OR < 7.93) are risk factors for poor glycemic status. Conclusion: Duration of DM >5 years and non-compliance with taking medication are risk factors for poor glycemic status in patients with type 2 DM.

A Model of Long-term Metabolic Progression of Type 2 Diabetes Mellitus for Evaluating Treatment Strategies

2006 ◽  
Vol 24 (S1) ◽  
pp. 5-19 ◽  
Author(s):  
Adrian Bagust ◽  
Marc Evans ◽  
Sophie Beale ◽  
Philip D. Home ◽  
Andrew S. Perry ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Treatment Strategies
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