Management of type 2 diabetes: evolving strategies for the treatment of patients with type 2 diabetes

Abstract

The prevalence of type 2 diabetes continues to increase at an alarming rate around the world, with even more people being affected by prediabetes. Although the pathogenesis and long-term complications of type 2 diabetes are fairly well known, its treatment has remained challenging, with only half of the patients achieving the recommended hemoglobin A1c target. This narrative review explores the pathogenetic rationale for the treatment of type 2 diabetes, with the view of fostering better understanding of the evolving treatment modalities. The diagnostic criteria including the role of hemoglobin A1c in the diagnosis of diabetes are discussed. Due attention is given to the different therapeutic maneuvers and their utility in the management of the diabetic patient. The evidence supporting the role of exercise, medical nutrition therapy, glucose monitoring, and antiobesity measures including pharmacotherapy and bariatric surgery is discussed. The controversial subject of optimum glycemic control in hospitalized and ambulatory patients is discussed in detail. An update of the available pharmacologic options for the management of type 2 diabetes is provided with particular emphasis on newer and emerging modalities. Special attention has been given to the initiation of insulin therapy in patients with type 2 diabetes, with explanation of the pathophysiologic basis for insulin therapy in the ambulatory diabetic patient. A review of the evidence supporting the efficacy of the different preventive measures is also provided.

Diabetes Mellitus and its Control by Ocimum sanctum Extract in Mice Diabetic Model

“…Control of postprandial hyperglycemia in diabetes is of great importance due to its close relation to the risk of micro and macro-vascular complications and death (Nyenwe et al, 2011). In the present investigation, experimental evaluation of the hypoglycemic potentials of O. sanctum has shown that the higher dose of extract (250 mg/kg body wt.)…”

“…With increasing incidence and mortality from its complications, prompt and adequate glycemic control in diabetes is paramount if management can meaningfully improve the quality of life and increase life expectancy (Nyenwe et al, 2011).…”

Hypoglycemic Efficacy of Catharanthus roseus and Opuntia ficusindica in Mice Diabetic Model

“…Control of postprandial hyperglycemia in diabetes is of great importance due to its close relation to the risk of micro and macro-vascular complications and death (Nyenwe et al, 2011). In this study, experimental evaluation of the hypoglycemic potentials of C. roseus and O. ficus-indica has shown that the higher dose of extract (250 mg/kg body wt.)…”

“…Diabetes mellitus (DM) is the third leading disease, after heart attack and cancer affecting almost every organ in the human body (Nyenwe et al, 2011) and is also called silent killer. This is a metabolic disorder of multiple etiologies characterized by absolute or relative deficiency of insulin secretion with or without varying degree of insulin resistance (Lin and Sun, 2010;Nyenwe et al, 2011).…”

“…This is a metabolic disorder of multiple etiologies characterized by absolute or relative deficiency of insulin secretion with or without varying degree of insulin resistance (Lin and Sun, 2010;Nyenwe et al, 2011).…”