Current antihyperglycemic treatment strategies for patients with type 2 diabetes mellitus

2009 ◽  
Vol 76 (12 suppl 5) ◽  
pp. S4-S11 ◽  
Author(s):  
Laurence Kennedy ◽  
Lawrence Blonde
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Treatment Strategies

scholarly journals Optimizing treatment goals for long-term health outcomes among patients with type 2 diabetes mellitus

2021 ◽  
Vol 9 (1) ◽  
pp. e002396
Author(s):  
Qian Shi ◽  
Yilu Lin ◽  
Vivian A Fonseca ◽  
Lizheng Shi
Keyword(s):  
Diabetes Mellitus ◽  
Blood Pressure ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Health Outcomes ◽  
Treatment Strategies ◽  
Optimal Treatment ◽  
Treatment Goals ◽  
Macrovascular Complication

IntroductionConsiderable confusions on treatment target have resulted from recent changes in guidelines. Evidence in medical guidelines came from clinical trials with highly selected patients, whereas treatment goals may differ in some subgroups. This study aimed to assess optimal treatment goals (A1C, blood pressure, low-density lipoprotein cholesterol (LDL-C)) for patients with type 2 diabetes mellitus (T2DM), which lead to optimal health outcomes by different treatment strategies.Research design and methodsA retrospective longitudinal study was conducted for veterans with T2DM by using US Veterans Affairs Administrative Database (2005−2015). Medical records were prepared for repeated evaluation performed at 6-month intervals and multivariate longitudinal regression was used to estimate the risk of microvascular and macrovascular complication events. Second-degree polynomial and splines were applied to identify the optimal goals in their associations with lowest risk of clinical outcomes, controlling for demographic characteristics, medical history, and medications.ResultsA total of 124 651 patients with T2DM were selected, with mean of 6.72 follow-up years. In the general population, to achieve the lowest risk of microvascular and macrovascular complication, the optimal goals were A1C=6.81%, LDL-C=109.10 mg/dL; and A1C=6.76%, LDL-C=111.65 mg/dL, systolic blood pressure (SBP)=130.60 mmHg, respectively. The optimal goals differed between age and racial subgroups. Lower SBP for younger patients and lower LDL-C for black patients were associated with better health outcomes.ConclusionsOptimal treatment goals were identified and multi-faceted treatment strategies targeting hyperglycemia and hyperlipidemia and hypertension may improve health outcome in veterans with T2DM. In addition to guidelines’ recommended goals, health systems may examine their own large diverse patients with T2DM for better quality of care.

Newer Treatment Strategies for the Management of Type 2 Diabetes Mellitus

2004 ◽  
Vol 17 (1) ◽  
pp. 49-54 ◽  
Author(s):  
Susan Cornell ◽  
Amber Briggs
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Glycosylated Hemoglobin ◽  
Treatment Options ◽  
Treatment Strategies ◽  
Treatment Goals ◽  
Microvascular And Macrovascular Complications

Type 2 diabetes mellitus is a multiorgan, metabolic disease associated with multiple microvascular and macrovascular complications. The incidence of type 2 diabetes is growing at an alarming rate. Achieving and maintaining near-normal blood glucose and glycosylated hemoglobin levels (A1C) are of the utmost importance. Existing treatment options for managing type 2 diabetes, which have primarily included sulfonylureas and biguanides, are insufficient at achieving these treatment goals alone, particularly if used long term. The need to explore newer and better treatment options that provide longer lasting glucose control and at the same time focus on targeting cardiovascular risk factors to minimize and prevent the serious complications associated with this multifaceted disease becomes quite obvious.

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