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Type 2 diabetes mellitus: managing hemoglobin A(1c) and beyond
Grant C Fowler1, Deepa A Vasudevan
1Department of Family and Community Medicine, University of Texas Medical School at Houston, 6431 Fannin JJL #324, Houston, TX 77030, USA.
Southern Medical Journal
|August 7, 2010
Summary
Achieving comprehensive glycemic control in type 2 diabetes mellitus requires managing glycated hemoglobin A1c (HbA1c), postprandial glucose (PPG), and fasting plasma glucose (FPG) levels. Combination therapies offer effective management with minimal risk of hypoglycemia and weight gain.
Area of Science:
- Endocrinology
- Metabolic Diseases
- Pharmacology
Background:
- Comprehensive glycemic control is crucial for managing type 2 diabetes mellitus (T2DM).
- Minimizing blood glucose fluctuations is essential to prevent microvascular and macrovascular complications.
- HbA1c alone may not reflect daily glucose variability.
Purpose of the Study:
- To emphasize the importance of reducing HbA1c, PPG, and FPG for effective glycemic control.
- To highlight patient safety, particularly minimizing hypoglycemia.
- To discuss the role of combination therapies in T2DM management.
Main Methods:
- Review of current understanding of glycemic control targets in T2DM.
- Analysis of the limitations of HbA1c as a sole indicator of glucose control.
- Evaluation of combination pharmacotherapies for T2DM.
Main Results:
- Glycemic control necessitates targeting HbA1c, PPG, and FPG.
- Hypoglycemia poses significant risks, including cognitive impairment.
- Combination regimens can achieve glycemic targets with reduced hypoglycemia and weight gain.
Conclusions:
- Effective T2DM management requires a multi-faceted approach to glycemic control.
- Combination therapies offer a viable strategy for achieving optimal glycemic targets while prioritizing patient safety.
- Minimizing hypoglycemia and weight gain are key considerations in treatment selection.
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