title: The need for reappraisal of type 2 diabetes mellitus management.
abstract: Type 2 diabetes is a multiorgan disease that results from the combination of insulin resistance and a beta-cell secretory defect. Because the complications associated with this disease are so significant, the importance of lowering glycosylated hemoglobin levels to within the normal range cannot be overemphasized. Thiazolidinediones (TZDs) modulate lipid metabolism, improve insulin sensitivity, exert numerous nonglycemic effects on the vasculature and lipid metabolism, and may improve many risk factors associated with the metabolic syndrome. Data from the UK Prospective Diabetes Study showed that conventional methods of managing type 2 diabetes, including sulfonylureas and biguanides, do not provide long-term glycemic control. Consequently, new treatment paradigms stressing earlier use of TZDs may lead to more durable glycemic control, facilitating the reduction of complications in patients with type 2 diabetes.
authors.affiliation: Division of Endocrinology and Metabolism, Department of Internal Medicine, University of Texas Southwestern Medical Center at Dallas, 5323 Harry Hines Blvd, Dallas, TX 75390-8857, USA. kathleen.wyne@utsouthwestern.edu
authors.forename: Kathleen L
authors.initials: KL
authors.lastname: Wyne
mesh_terms: D003924:Diabetes Mellitus, Type 2 / Q000503:physiopathology / Q000628:therapy*; D005943:Gluconeogenesis; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D007333:Insulin Resistance; D024821:Metabolic Syndrome / Q000503:physiopathology; D011322:Primary Prevention; D012307:Risk Factors; D013844:Thiazoles / Q000627:therapeutic use; D045162:Thiazolidinediones
chemical_list: D007004:Hypoglycemic Agents; D013844:Thiazoles; D045162:Thiazolidinediones; C089946:2,4-thiazolidinedione