Managing type 2 diabetes in the primary care setting: beyond glucocentricity.
Successful management of type 2 diabetes mellitus (T2DM) requires attention to additional conditions often associated with hyperglycemia including overweight or obesity, dyslipidemia and hypertension, as each has some relationship with microvascular or macrovascular complications. Because control of cardiovascular risk factors is as important as glucose control in T2DM, these risk factors need to be addressed, and it is critical that antidiabetes medications do not exacerbate these risk factors. A patient-centered approach to treatment in which clinicians maximize patient involvement in the selection of antidiabetes therapy may lead to increased adherence and improved clinical outcomes. The incretin hormones, which include glucagon-like peptide-1 (GLP-1), are involved in glucoregulation and have become an important focus of T2DM research and treatment. Incretin-based therapies, such as the glucagon-like peptide-1 receptor agonists and the dipeptidyl peptidase-IV inhibitors, have shown beneficial effects on hyperglycemia, weight, blood pressure and lipids with a low incidence of hypoglycemia.
Kuritzky
Louis
L
University of Florida College of Medicine, Gainesville, 32601, USA. lkuritzky@aol.com
D000218:Adamantane / Q000031:analogs & derivatives / Q000627:therapeutic use; D001786:Blood Glucose / Q000378:metabolism; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy / Q000628:therapy*; D004151:Dipeptides / Q000627:therapeutic use; D054873:Dipeptidyl-Peptidase IV Inhibitors / Q000627:therapeutic use; D000077270:Exenatide; D052216:Glucagon-Like Peptide 1 / Q000031:analogs & derivatives / Q000627:therapeutic use; D006801:Humans; D006943:Hyperglycemia / Q000188:drug therapy / Q000628:therapy; D007004:Hypoglycemic Agents / Q000008:administration & dosage / Q000627:therapeutic use; D000069450:Liraglutide; D009570:Nitriles / Q000627:therapeutic use; D009765:Obesity / Q000628:therapy; D010349:Patient Compliance; D010455:Peptides / Q000008:administration & dosage / Q000627:therapeutic use; D010880:Piperidines / Q000627:therapeutic use; D057285:Precision Medicine; D011320:Primary Health Care; D011719:Pyrazines / Q000627:therapeutic use; D011759:Pyrrolidines / Q000627:therapeutic use; D012307:Risk Factors; D000068900:Sitagliptin Phosphate; D014230:Triazoles / Q000627:therapeutic use; D014498:Uracil / Q000031:analogs & derivatives / Q000627:therapeutic use; D014688:Venoms / Q000008:administration & dosage / Q000627:therapeutic use; D000077597:Vildagliptin
D001786:Blood Glucose; D004151:Dipeptides; D054873:Dipeptidyl-Peptidase IV Inhibitors; D007004:Hypoglycemic Agents; D009570:Nitriles; D010455:Peptides; D010880:Piperidines; D011719:Pyrazines; D011759:Pyrrolidines; D014230:Triazoles; D014688:Venoms; C541736:taspoglutide; D014498:Uracil; C534611:rGLP-1 protein; D000069450:Liraglutide; D052216:Glucagon-Like Peptide 1; C502994:saxagliptin; D000077270:Exenatide; D000077597:Vildagliptin; C520853:alogliptin; D000218:Adamantane; D000068900:Sitagliptin Phosphate