title: Complex type 2 diabetes mellitus--management challenges and pitfalls.
abstract: BACKGROUND
  Patients with type 2 diabetes mellitus frequently have comorbidities that complicate the management of their disease. Many of these patients are prescribed multiple medications to manage hyperglycaemia, hypertension and other comorbidities. Clinicians who manage these patients must deal with the challenge of adjusting multiple medications in the face of renal failure and cardiovascular disease as the disease progresses, as well as tailoring therapy to help patients overcome intolerances and adverse effects.
  
  
  OBJECTIVE
  This article explores some of the issues in managing the complex patient, including non-adherence and the challenges associated with achieving glycaemic control in patients with cardiovascular disease and renal impairment.
  
  
  CONCLUSIONS
  Generalists, specifically general practitioners, are well suited to address the complexities of the management of type 2 diabetes mellitus patients. They need to be able to assess the risks and benefits of each treatment decision in light of the patient's glycaemic control, cardiovascular status, renal function and motivation.
authors.affiliation: Corio Medical Clinic, Geelong, Victoria. mfgkennedy@coriomedical.com.au
authors.forename: Mark
authors.initials: M
authors.lastname: Kennedy
authors.forename: Adam
authors.initials: A
authors.lastname: Roberts
mesh_terms: D001786:Blood Glucose / Q000378:metabolism; D002318:Cardiovascular Diseases / Q000150:complications*; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000150:complications* / Q000188:drug therapy*; D003928:Diabetic Nephropathies / Q000503:physiopathology / Q000517:prevention & control* / Q000652:urine; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D055118:Medication Adherence
chemical_list: D001786:Blood Glucose; D006442:Glycated Hemoglobin