title: Management of hyperglycemia in type 2 diabetes: evidence and uncertainty.
abstract: The panoply of treatment algorithms, periodically released to improve guidance, is one mean to face therapeutic uncertainty in pharmacological management of hyperglycemia in type 2 diabetes, especially after metformin failure. Failure of recent guidelines to give advice on the use of specific antidiabetic drugs in patients with co-morbidity may generate further uncertainty, given the frequent association of type 2 diabetes with common comorbidity, including, although not limited to obesity, cardiovascular disease, impaired renal function, and frailty. The Italian Association of Diabetologists (Associazione Medici Diabetologi, AMD) recognized the need to develop personalized treatment plans for people with type 2 diabetes, taking into account the patients' individual profile (phenotype), with the objective of the safest possible glycemic control. As not every subject with type 2 diabetes benefits from intensive glycemic control, flexible regimens of treatment with diabetes drugs (including insulin) are needed for reaching individualized glycemic goals. Whether personalized diabetology will improve the quality healthcare practice of diabetes management is unknown, but specific research has been launched.
authors.affiliation: Department of Clinical and Experimental Medicine, Second University of Naples, Naples, Italy. katherine.esposito@unina2.it
authors.forename: Katherine
authors.initials: K
authors.lastname: Esposito
authors.forename: Sandro
authors.initials: S
authors.lastname: Gentile
authors.forename: Riccardo
authors.initials: R
authors.lastname: Candido
authors.forename: Alberto
authors.initials: A
authors.lastname: De Micheli
authors.forename: Marco
authors.initials: M
authors.lastname: Gallo
authors.forename: Gerardo
authors.initials: G
authors.lastname: Medea
authors.forename: Antonio
authors.initials: A
authors.lastname: Ceriello
mesh_terms: D000465:Algorithms; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000188:drug therapy*; D006801:Humans; D006943:Hyperglycemia / Q000188:drug therapy* / Q000209:etiology; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D009765:Obesity / Q000150:complications; D010347:Patient Care Planning; D017410:Practice Guidelines as Topic; D057285:Precision Medicine
chemical_list: D007004:Hypoglycemic Agents