Pathogenesis and treatment of type 2 (noninsulin-dependent) diabetes mellitus (NIDDM)

Noninsulin-dependent diabetes mellitus is a major health problem affecting nearly 100,000,000 million people world-wide. Its pathogenesis is multifactorial involving both genetic (e.g. impaired insulin-secretion) and acquired (e.g. insulin-resistance) factors which cause overproduction of glucose and inefficient glucose utilization. The cost and suffering from this disease are primarily due to its longterm complications which controlled clinical trials indicate can be prevented with good glycemic control. However most patients are currently not under satisfactory control. More intensive efforts with judicious combinations of presently available modalities by specialists having educational and motivational support teams and the expected introduction of new therapeutic agents should make it possible for most patients to achieve levels of glycemic control which will prevent their developing complications.