[Management of blood glucose--target of the management and its practice].
Accumulating evidence supports that management of blood glucose levels is critical for the prevention of diabetic vascular complications including macroangiopathy. Several therapeutic modalities are available in the management of blood glucose levels. In type 2 diabetes with obesity, achievement of body weight control with intensive caloric restriction is essential. Sulfonylurea remains the central drug in the management in insulin-independent patients without obesity. For patients with insulin resistance, biguanide or thiazolidinediones are the drugs of choice. For patients with postprandial hyperglycemia, a-glucosidase inhibitors and meglitinide analogs should be considered. Combination of some of these drugs has additive effect for patients with suboptimal blood glucose control with monotherapy. When the above therapies fail, we should not hesitate to start insulin.
Ishibashi
Shun
S
Division of Endocrinology and Metabolism, Department of Medicine, Jichi Medical University.
D001549:Benzamides / Q000627:therapeutic use; D001786:Blood Glucose; D003131:Combined Modality Therapy; D048909:Diabetes Complications; D003920:Diabetes Mellitus / Q000097:blood / Q000628:therapy*; D003925:Diabetic Angiopathies / Q000209:etiology / Q000517:prevention & control; D004038:Diet, Reducing; D004791:Enzyme Inhibitors / Q000627:therapeutic use; D065089:Glycoside Hydrolase Inhibitors; D006801:Humans; D006943:Hyperglycemia / Q000097:blood / Q000628:therapy*; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D007333:Insulin Resistance; D008019:Life Style; D009765:Obesity / Q000150:complications; D019518:Postprandial Period; D013453:Sulfonylurea Compounds / Q000627:therapeutic use; D045162:Thiazolidinediones / Q000627:therapeutic use
D001549:Benzamides; D001786:Blood Glucose; D004791:Enzyme Inhibitors; D065089:Glycoside Hydrolase Inhibitors; D007004:Hypoglycemic Agents; D013453:Sulfonylurea Compounds; D045162:Thiazolidinediones; C030516:meglitinide