title: Tailoring treatment to the individual in type 2 diabetes practical guidance from the Global Partnership for Effective Diabetes Management.
abstract: Good glycaemic control continues to be the most effective therapeutic manoeuvre to reduce the risk of development and/or progression of microvascular disease, and therefore remains the cornerstone of diabetes management despite recent scepticism about tight glucose control strategies. The impact on macrovascular complications is still a matter of debate, and so glycaemic control strategies should be placed in the context of multifactorial intervention to address all cardiovascular risk factors. Approaches to achieve glycaemic targets should always ensure patient safety, and results from recent landmark outcome studies support the need for appropriate individualisation of glycaemic targets and of the means to achieve these targets, with the ultimate aim to optimise outcomes and minimise adverse events, such as hypoglycaemia and marked weight gain. The primary goal of the Global Partnership for Effective Diabetes Management is the provision of practical guidance to improve patient outcomes and, in this article, we aim to support healthcare professionals in appropriately tailoring type 2 diabetes treatment to the individual. Patient groups requiring special consideration are identified, including newly diagnosed individuals with type 2 diabetes but no complications, individuals with a history of inadequate glycaemic control, those with a history of cardiovascular disease, children and individuals at risk of hypoglycaemia. Practical guidance specific to each group is provided.
authors.affiliation: University of Pisa, Pisa, Italy. delprato@immr.med.unipi.it
authors.forename: S
authors.initials: S
authors.lastname: Del Prato
authors.forename: J
authors.initials: J
authors.lastname: LaSalle
authors.forename: S
authors.initials: S
authors.lastname: Matthaei
authors.forename: C J
authors.initials: CJ
authors.lastname: Bailey
mesh_terms: D000328:Adult; D001786:Blood Glucose / Q000378:metabolism; D002648:Child; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000175:diagnosis / Q000188:drug therapy*; D003925:Diabetic Angiopathies / Q000097:blood / Q000175:diagnosis / Q000188:drug therapy*; D006801:Humans; D007003:Hypoglycemia / Q000209:etiology / Q000517:prevention & control; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D009765:Obesity / Q000150:complications; D050177:Overweight / Q000150:complications; D017410:Practice Guidelines as Topic; D013851:Thinness / Q000150:complications
chemical_list: D001786:Blood Glucose; D007004:Hypoglycemic Agents
references.citation: Int J Clin Pract. 2005 Nov;59(11):1309-16
references.pmid: 16236086
references.citation: JAMA. 2003 Oct 22;290(16):2159-67
references.pmid: 14570951
references.citation: J Clin Endocrinol Metab. 2008 Apr;93(4):1143-52
references.pmid: 18182449
references.citation: Circulation. 2008 Feb 26;117(8):1018-27
references.pmid: 18268145
references.citation: Diab Vasc Dis Res. 2009 Oct;6(4):283-7
references.pmid: 20368223
references.citation: J Clin Endocrinol Metab. 2009 Feb;94(2):410-5
references.pmid: 19066300
references.citation: Lancet. 2009 May 23;373(9677):1765-72
references.pmid: 19465231
references.citation: N Engl J Med. 2009 Jan 8;360(2):129-39
references.pmid: 19092145
references.citation: Int J Clin Pract Suppl. 2007 Jun;(153):3-9
references.pmid: 17594388
references.citation: N Engl J Med. 2008 Oct 9;359(15):1577-89
references.pmid: 18784090
references.citation: N Engl J Med. 2008 Jun 12;358(24):2560-72
references.pmid: 18539916
references.citation: N Engl J Med. 2005 Dec 22;353(25):2643-53
references.pmid: 16371630
references.citation: Nutr Metab Cardiovasc Dis. 2009 Nov;19(9):604-12
references.pmid: 19427768
references.citation: Lancet. 1998 Sep 12;352(9131):837-53
references.pmid: 9742976
references.citation: Pediatr Ann. 2005 Sep;34(9):686-97
references.pmid: 16222946
references.citation: N Engl J Med. 2008 Jun 12;358(24):2545-59
references.pmid: 18539917
references.citation: Int J Clin Pract Suppl. 2007 Dec;(157):22-30
references.pmid: 17991188
references.citation: N Engl J Med. 2003 Jun 5;348(23):2294-303
references.pmid: 12788993
references.citation: Int J Clin Pract Suppl. 2007 Dec;(157):16-21
references.pmid: 17991187
references.citation: JAMA. 2002 May 15;287(19):2563-9
references.pmid: 12020338
references.citation: Int J Clin Pract. 2005 Nov;59(11):1345-55
references.pmid: 16236091
references.citation: Br J Clin Pharmacol. 2009 Feb;67(2):242-9
references.pmid: 19260863
references.citation: Diabetes Care. 2009 Jan;32(1):187-92
references.pmid: 19092168
references.citation: Diabetologia. 2009 Jul;52(7):1219-26
references.pmid: 19373446
references.citation: J Indian Med Assoc. 2008 Nov;106(11):747-50
references.pmid: 19368101