Diagnosis and management of type 2 diabetes and prediabetes

Treatment of type 2 diabetes mellitus (T2DM), a progressive disease, requires early and appropriate therapies, with frequent monitoring and reassessment to make certain goals are attained. Chronic hyperglycemia can cause macrovascular and microvascular complications, many of which may be apparent on initial diagnosis. As beta-cell function deteriorates and insulin resistance intensifies, patients find that oral pharmacologic therapy is becoming less effective at minimizing the effects of chronic hyperglycemia. Eventually, most will require exogenous insulin therapy. Primary care physicians manage over 90% of T2DM patients, so we must have a better understanding of our roles as patient educators, advocates, and medical providers, and do everything in our power to help our patients achieve the lowest and safest glycated hemoglobin (A1C) possible.