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[Therapeutic strategies for type 2 diabetes]
1Service d'endocrinologie, diabétologie, nutrition Centre hospitalier universitaire de Grenoble B.P. 217 38043 Grenoble. shamili@ujf-grenoble.fr
La Revue Du Praticien
|July 9, 2003
Summary
Large trials for type 2 diabetes prompt new strategies. Early combination therapy, particularly metformin-glitazone, is recommended for obese patients, aiming for better glycemic control.
Area of Science:
- Endocrinology
- Metabolic Diseases
- Pharmacotherapy
Background:
- Traditional type 2 diabetes management involves stepwise therapy, starting with lifestyle changes, then monotherapy, and finally bi-therapy.
- This classical approach is being re-evaluated based on recent large-scale therapeutic trial outcomes.
Purpose of the Study:
- To reconsider the conventional treatment strategy for type 2 diabetes in light of new evidence.
- To explore earlier and more aggressive therapeutic interventions for managing type 2 diabetes.
Main Methods:
- Review of results from large therapeutic trials in type 2 diabetes.
- Analysis of emerging treatment paradigms, including the role of glitazones and combination therapies.
Main Results:
- The advent of glitazones suggests that bi-therapy, specifically metformin-glitazone, should be considered early in treatment, especially for obese or overweight patients.
- Newer strategies advocate for earlier and more ambitious glycemic control objectives.
Conclusions:
- The classical stepwise approach to type 2 diabetes treatment requires reconsideration.
- Early initiation of combination therapy, particularly metformin-glitazone in specific patient populations, and earlier achievement of glycemic targets represent a shift in management strategies.