title: Current treatment approaches to type 2 diabetes mellitus: successes and shortcomings.
abstract: Diabetes mellitus affects approximately 17 million adults in the United States and has profound implications in terms of long-term microvascular and macrovascular complications and their associated costs. In type 2 diabetes, insulin resistance and a relative beta-cell defect are the underlying pathologic problems leading to hyperglycemia. Notably, insulin resistance is also associated with obesity, dyslipidemia, and hypertension. Diabetes can be defined as a disease of accelerated cardiovascular deterioration associated with elevated blood glucose levels. Glycemic control has been shown to reduce the long-term complications associated with diabetes. Although medical nutrition therapy and appropriately prescribed increased physical activity are important components of a diabetes management plan, most patients need medication to lower glucose to near-normal levels. Therapeutic options for treating hyperglycemia include sulfonylureas and other insulin secretagogues, biguanides, alpha-glucosidase inhibitors, thiazolidinediones, and insulin. An antidiabetic agent that improves insulin sensitivity is an excellent choice for early treatment of type 2 diabetes because it may delay or prevent complications associated with this disease. Because of the progressive nature of type 2 diabetes, aggressive intervention early in the course of the disease, including combination therapy, is often necessary.
authors.affiliation: Queen City Physicians, Cincinnati, Ohio, USA.
authors.forename: Francis M
authors.initials: FM
authors.lastname: Collins
mesh_terms: D000328:Adult; D001786:Blood Glucose / Q000032:analysis; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000175:diagnosis / Q000191:economics / Q000209:etiology* / Q000628:therapy*; D004035:Diet Therapy; D019468:Disease Management; D015444:Exercise / Q000502:physiology; D017048:Health Care Costs; D006801:Humans; D006949:Hyperlipidemias / Q000150:complications / Q000628:therapy; D006973:Hypertension / Q000150:complications / Q000628:therapy; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D007333:Insulin Resistance; D014481:United States
chemical_list: D001786:Blood Glucose; D007004:Hypoglycemic Agents