Managing diabetes in Asia: overcoming obstacles and the role of DPP-IV inhibitors.
Asia bears the world's greatest burden of type 2 diabetes (T2DM) and prevalence is increasing rapidly. Compared to other races, Asians develop T2DM younger, at a lower degree of obesity, suffer longer from its complications and die earlier. Curbing this epidemic requires an integrated, risk-based, and multidisciplinary approach. Inadequately managed T2DM has macrovascular and microvascular sequelae, Asians with T2DM being particularly susceptible to diabetic nephropathy. Earlier and more intensive monitoring and management of risk factors are required, especially for patients with, or at risk of, renal impairment. Particular challenges of T2DM management in Asia include: lack of access to specialist healthcare, insufficient clinical evaluation and delayed diagnosis. As in Caucasians, conventional treatment modalities are limited by deteriorating glycaemic control with disease progression and there is an unmet need for efficacious, safe, cost-effective and convenient pharmacotherapies for treating different stages of T2DM and preventing its complications, particularly in high-risk patients. There is a trend towards increasing use of DPP-IV inhibitors, which are no less efficacious and safe in Asians than Caucasians and may have some advantages over existing oral antidiabetic agents, particularly for certain high-risk groups. Such agents may play a significant future role in the management of T2DM.
Department of Endocrinology, Chinese PLA General Hospital, Beijing, China. muyiming@301hospital.com.cn
Yi-Ming
YM
Mu
Anoop
A
Misra
John M F
JM
Adam
Siew Pheng
SP
Chan
Francis C C
FC
Chow
Elaine Cheeay
EC
Cunanan
Chaicharn
C
Deerochanawong
Hak Chul
HC
Jang
Nguyen Thy
NT
Khue
Wayne H-H
WH
Sheu
Kevin E K
KE
Tan
D000328:Adult; D000368:Aged; D001208:Asia / Q000453:epidemiology; D044466:Asian People; D015992:Body Mass Index; D003362:Cost-Benefit Analysis; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy* / Q000191:economics / Q000453:epidemiology; D003928:Diabetic Nephropathies / Q000188:drug therapy* / Q000191:economics / Q000453:epidemiology; D054873:Dipeptidyl-Peptidase IV Inhibitors / Q000191:economics / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D006943:Hyperglycemia / Q000188:drug therapy* / Q000191:economics / Q000453:epidemiology; D007004:Hypoglycemic Agents / Q000191:economics / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000188:drug therapy* / Q000191:economics / Q000453:epidemiology; D012307:Risk Factors
D054873:Dipeptidyl-Peptidase IV Inhibitors; D007004:Hypoglycemic Agents