scholarly journals Type 2 diabetes therapeutic strategies: why don't we see the «ELEPHANT» in the room?

2016 ◽  
Vol 19 (4) ◽  
pp. 341-349 ◽  
Author(s):  
Shmuel Levit ◽  
Shmuel Giveon ◽  
Yury I. Philippov ◽  
Ivan Panchev Domuschiev ◽  
Amir Zivony

During the past two decades, the unequivocally recommended treatment method of Type 2 diabetes mellitus was insulin administration and intensification in the earliest possible stage of the diagnosis. This approach is not only unfounded but was never scientifically proven. Yet, it has been zealously advocated to medical professionals. In fact, a sound body of evidence disproves this long-standing treatment approach. This method is a cornerstone of, what we now know to be two great illusions of past century, namely, glucocentrism and intensification. Numerous recently published studies provide alarming data regarding serious side effects of blind intensification and insulin overdosing in T2DM. They raise major concerns and call for revision of the traditional approach. Since insulin is an integral and deeply rooted part of the intensification agenda of treating T2DM, it has now suffered a serious drawback. Alternatively, in this review authors present the novel Gravicentric (Energy) concept of T2DM acceptance and therapy. They offer a new classification of anti-diabetes drugs based on their energy effect and present their Gravicentric Algorithm for wide practical utilization. For that reason, the "ELEPHANT" abbreviation was found as a helpful reminder. Viewing T2DM as disease of energy balance together with anti – energy drugs implementation provide medical doctors an unique opportunity to transform T2DM from "slowly – progressive" disease to rapidly reversible condition, which it actually is.

Gene ◽  
2021 ◽  
Vol 769 ◽  
pp. 145229
Author(s):  
Freda Lalrohlui ◽  
John Zohmingthanga ◽  
Vanlal hruaii ◽  
Andrew Vanlallawma ◽  
Nachimuthu Senthil Kumar

2019 ◽  
Vol 234 (9) ◽  
pp. 14896-14905 ◽  
Author(s):  
Gaohua Li ◽  
Hua Liu ◽  
Chunlian Ma ◽  
Yanfang Chen ◽  
Jinju Wang ◽  
...  

2019 ◽  
Vol 10 ◽  
pp. 204201881987540 ◽  
Author(s):  
Alexis Sudlow ◽  
Carel W le Roux ◽  
Dimitri J Pournaras

Treating type 2 diabetes mellitus (T2DM) in patients with obesity remains a challenge for physicians, endocrinologists and surgeons, a fact supported by uncontroverted evidence from studies looking at mortality and associated morbidity. Metabolic surgery remains the most effective treatment for obesity and T2DM with evidence demonstrating an improvement or resolution of symptoms of T2DM and a reduction in a mortality and rates of cardiovascular events compared with pharmacotherapy alone. While these results are promising, two important limitations must be recognized and addressed. With regards to long-term remission of T2DM, the metabolic benefits of bariatric surgery appear to fatigue with time and a proportion of patients will not maintain normoglycaemia without pharmacotherapy. Second, there has been noteworthy progress in the development of several classes of medications for the treatment of T2DM which were unavailable when the original studies comparing the effects of bariatric surgery with pharmacotherapy were conducted. Recognizing the need for further treatment following metabolic surgery for long-term disease control in conjunction with the availability of newer medications offering more effective, nonsurgical treatment presents a critical turning point in treatment treating obesity. While the traditional approach would be to determine the superiority (or non-inferiority) of these agents compared with surgery, clinicians and surgeons must acknowledge the limitations of this attitude towards treatment given evidence from fields such as cancer, where a combinational approach is the gold standard. Recent advances in pharmacotherapy, present not only a novel approach to medical therapy but a renewed impetus to investigate what can be achieved through multimodal care.


2013 ◽  
Vol 59 (5) ◽  
pp. 72-80
Author(s):  
Iu Sh Khalimov

The incidence of hypoglycemia remains rather high among the population of patients with type 2 diabetes mellitus (DM2) especially in those treated with the traditional oral hypoglycemic agents. Hypoglycemia is one of the most frequent adverse events encountered by a physician dealing with diabetic (DM2) patients. At the same time, the novel approaches are currently available that allow this clinical condition to be avoided.


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