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Type II diabetes mellitus

S V Edelman1

  • 1Division of Endocrinology and Metabolism, University of California, San Diego, USA.

Advances in Internal Medicine
|March 20, 1998
PubMed
Summary
This summary is machine-generated.

Type II diabetes management involves lifestyle changes and medications like metformin and sulfonylureas. Effective treatment strategies, including oral agents and insulin, aim to control hyperglycemia and reduce cardiovascular risks.

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Area of Science:

  • Endocrinology
  • Metabolic Disorders
  • Cardiovascular Health

Background:

  • Type II diabetes is a growing global health concern, often co-occurring with obesity, hypertension, and dyslipidemia.
  • These comorbidities significantly increase cardiovascular morbidity and mortality.
  • Key pathological defects include excessive hepatic glucose production, insulin resistance, and impaired beta-cell function.

Purpose of the Study:

  • To outline the management of Type II diabetes, emphasizing therapeutic goals and strategies.
  • To discuss the role of nonpharmacologic and pharmacologic interventions.
  • To highlight the importance of individualized treatment selection.

Main Methods:

  • Initiation of nonpharmacologic therapy (diet and exercise) upon diagnosis.

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  • Introduction of oral antidiabetic agents if glycemic goals are unmet after 3 months.
  • Consideration of combination therapy with oral agents or insulin when monotherapy is insufficient.

    • Main Results:

    • Nonpharmacologic therapy is the cornerstone, with specific dietary recommendations (40-50% complex carbs, 10-20% protein, monounsaturated fats).
    • Oral agents like metformin, acarbose, and troglitazone offer different mechanisms to improve glycemic control.
    • Combination therapy and insulin regimens (including bedtime intermediate-acting insulin) can effectively manage glycemia in various patient profiles.

    Conclusions:

    • Aggressive management of hyperglycemia and associated metabolic conditions is crucial for improving quality of life and achieving long-term cost savings.
    • Therapeutic goals for Type II diabetes should align with those for Type I diabetes.
    • Individualized treatment selection based on patient characteristics is essential for optimal outcomes.