Primary care diabetes. What options are there?
BACKGROUND
The recognised incidence of type 2 diabetes mellitus is increasing dramatically and the vital importance of good diabetes control in patients with both type 1 and type 2 diabetes is now well established. Weight reduction and oral hypoglycaemic therapy has been accompanied by new drug treatment options in type 2 diabetes, while refinements in insulin delivery are more relevant for patients with type 1 diabetes.


OBJECTIVE
To review currently available drug therapies and management strategies for type 2 diabetes, and optimal insulin treatment regimens for type 1 diabetes.


CONCLUSIONS
Weight reduction and regular exercise remain major lifestyle intervention priorities in type 2 diabetes. Metformin should be used early in overweight patients, and sulphonylureas as additive therapy. Acarbose, orlistat and the thiazolidinediones all have potential roles in the treatment of type 2 diabetes where cardiovascular risk factor reduction is also of vital importance. Insulin analogues and continuous subcutaneous insulin infusion via insulin pumps will help to optimise insulin replacement regimens for patients with type 1 diabetes mellitus.
Yeap
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BB
University of Western Australia, Department of Endocrinology and Diabetes, Fermantle Hospital, Western Australia. byeap@cyllene.uwa.edu.au
D002985:Clinical Protocols; D003922:Diabetes Mellitus, Type 1 / Q000628:therapy*; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy / Q000628:therapy*; D019468:Disease Management; D006801:Humans; D006973:Hypertension / Q000188:drug therapy; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D007328:Insulin / Q000627:therapeutic use; D009203:Myocardial Infarction / Q000517:prevention & control; D011320:Primary Health Care / Q000379:methods*; D015431:Weight Loss
D007004:Hypoglycemic Agents; D007328:Insulin