[Therapeutic strategies for type 2 diabetes].
The results of the large therapeutic trials for type 2 diabetes have led to a reconsideration of the "classical" treatment strategy. Until now, the strategy consisted of starting with a modification of the lifestyle, then in the event of failure, without privileging one therapeutic class over another, to prescribe a monotherapy, in increasing doses until the maximum dose is reached, and only then to pass to a bi-therapy up to it's maximum dose; Since the apparition of the glitazones, bi-therapy based in particular on the association metformin-glitazone, should be envisaged from diagnosis in patients who are obese or heavily overweight. New strategies now in the process of being elaborated suggest to treat type 2 diabetes much earlier and with much more ambitious glycaemic objectives.
Halimi
Serge
S
Service d'endocrinologie, diabétologie, nutrition Centre hospitalier universitaire de Grenoble B.P. 217 38043 Grenoble. shamili@ujf-grenoble.fr
D000284:Administration, Oral; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy* / Q000503:physiopathology; D004359:Drug Therapy, Combination; D006801:Humans; D006943:Hyperglycemia / Q000503:physiopathology; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D024821:Metabolic Syndrome / Q000503:physiopathology; D010641:Phenotype; D017410:Practice Guidelines as Topic; D013844:Thiazoles / Q000627:therapeutic use*
D007004:Hypoglycemic Agents; D013844:Thiazoles