Addressing the need to tailor treatment to the spectrum of type 2 diabetes: new perspectives.
Type 2 diabetes mellitus is characterized by the progressive loss of beta cell function, which occurs after many years of insulin resistance. Within this definition, clinicians may see a diverse array of presentations, suggesting different proportions of these two pathogenic factors and a complex etiology. There are also differences in the rate of type 2 diabetes progression in each patient, so treatments must be reviewed frequently to respond to changing severity of pathophysiologies. This article first considers some of the heritable factors and the pathogenic heterogeneity of type 2 diabetes. Relevant socioeconomic and demographic factors influencing disease development are reviewed after that, while emphasizing how a patient's treatment requires changes over time.
Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts 02215, USA. arolla@caregroup.harvard.edu
Arturo R
AR
Rolla
D044383:Black People / Q000706:statistics & numerical data; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology / Q000235:genetics / Q000503:physiopathology / Q000628:therapy*; D018450:Disease Progression; D004777:Environment; D020022:Genetic Predisposition to Disease; D006630:Hispanic or Latino / Q000706:statistics & numerical data; D006801:Humans; D008019:Life Style; D009154:Mutation; D012307:Risk Factors; D014481:United States / Q000453:epidemiology; D001741:Black or African American