Type 2 diabetes care and the law of endocrine parsimony

Diabetes care has become more and more complex and challenging. For the practicing physician, advances in pathophysiology and diagnostic/ monitoring tools are welcome, as they enhance understanding of the syndrome, its causation, and its natural history. The surfeit of drug classes and drugs available today however, create confusion and chaos as well. The almost infinite number of permutations and combinations that these can be used, poses a dilemma for the diabetes care professional. This communication proposes the Law of Endocrine Parsimony, and relates it to therapeutic targets as well as strategies in type 2 diabetes care. The Law of Endocrine Parsimony assists in decision making by positing: Hormones which are secreted in excess must be reduced, before trying to increase hormones which are relatively deficient, while managing diabetes.