Type 2 Diabetes Mellitus: An Evidence-Based Approach to Practical Management

This chapter reviews all available noninsulin hypoglycemic therapies and aims to provide a succinct, evidence-based reference for use of these agents in clinical practice. The cornerstone of type 2 diabetes (DM) treatment is dietary lifestyle modifications, exercise, and weight management. Though these measures should be part of every treatment regimen, the addition of pharmacologic treatment should be implemented soon after diagnosis if blood glucose control is not achieved. Early intervention with achievement of normoglycemia reduces long term complications and has the potential to slow progression of the disease. Combination therapy addressing the different pathophysiological pathways responsible for the development of type 2 diabetes represents a physiological approach to treatment, and usually yields higher rates of success. Failure of oral hypoglycemic agents occurs over time in the majority of patients, and insulin therapy is eventually needed.

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