Overcoming Challenges in Type 2 Diabetes Management to Improve Outcomes
Overcoming Challenges in Type 2 Diabetes Management to Improve Outcomes
As obesity and Type 2 diabetes mellitus reach epidemic proportions worldwide, glycemic control and prevention of complications have become even more critical. We searched studies published between January 2006 and January 2010 to identify and discuss the challenges facing healthcare professionals and patients in reaching glycemic targets. MEDLINE and Derwent Drug File searches were conducted with the following search terms: Type 2 diabetes mellitus, medication adherence, antihyperglycemic agents, glucose control, and clinical inertia. In this article we will outline the commonly used medications and present the advantages and disadvantages of each class of drug. Additionally, we will present the dipeptidyl peptidase-4 inhibitors and their place in the treatment of patients with Type 2 diabetes mellitus.
Diabetes mellitus has reached epidemic proportions; an estimated 8% of people in the USA (24 million people) have diabetes (diagnosed and undiagnosed) and 90–95% of those diagnosed have Type 2 diabetes mellitus (T2DM). Patients who are diagnosed with diabetes have a glycated hemoglobin (HbA1c) level of 6.5% or more, fasting plasma glucose (FPG) of 126 mg/dl (7.0 mmol/l) or more, 2-h postprandial glucose (PPG) of 200 mg/dl (11.1 mmol/l) or more, or random plasma glucose levels of 200 mg/dl (11.1 mmol/l) or more. Additionally, more than 57 million people in the USA are estimated to be prediabetic (FPG: 100 to <126 mg/dl [conversion factor mg/dl × 0.0555 = mmol/l] and/or PPG: 140 to <200 mg/dl). Of those diagnosed with T2DM, approximately 60% are cared for by primary-care physicians.
In the majority of patients with T2DM and hypertension, the overall burden of diabetes can be reduced most effectively by adding intensive blood pressure management and lipid control to glycemic regulation. Unfortunately, the challenges healthcare professionals and patients must overcome to ensure treatment success continue to persist. The drug armamentarium has grown in recent years and now provides the physician with treatment regimens that can be tailored to the individual patient's needs and, thus, provides the tools necessary for a lifetime of glycemic control. The challenges that still face healthcare professionals and the advantages and disadvantages of each class of drug will be discussed.
Abstract and Introduction
Abstract
As obesity and Type 2 diabetes mellitus reach epidemic proportions worldwide, glycemic control and prevention of complications have become even more critical. We searched studies published between January 2006 and January 2010 to identify and discuss the challenges facing healthcare professionals and patients in reaching glycemic targets. MEDLINE and Derwent Drug File searches were conducted with the following search terms: Type 2 diabetes mellitus, medication adherence, antihyperglycemic agents, glucose control, and clinical inertia. In this article we will outline the commonly used medications and present the advantages and disadvantages of each class of drug. Additionally, we will present the dipeptidyl peptidase-4 inhibitors and their place in the treatment of patients with Type 2 diabetes mellitus.
Introduction
Diabetes mellitus has reached epidemic proportions; an estimated 8% of people in the USA (24 million people) have diabetes (diagnosed and undiagnosed) and 90–95% of those diagnosed have Type 2 diabetes mellitus (T2DM). Patients who are diagnosed with diabetes have a glycated hemoglobin (HbA1c) level of 6.5% or more, fasting plasma glucose (FPG) of 126 mg/dl (7.0 mmol/l) or more, 2-h postprandial glucose (PPG) of 200 mg/dl (11.1 mmol/l) or more, or random plasma glucose levels of 200 mg/dl (11.1 mmol/l) or more. Additionally, more than 57 million people in the USA are estimated to be prediabetic (FPG: 100 to <126 mg/dl [conversion factor mg/dl × 0.0555 = mmol/l] and/or PPG: 140 to <200 mg/dl). Of those diagnosed with T2DM, approximately 60% are cared for by primary-care physicians.
In the majority of patients with T2DM and hypertension, the overall burden of diabetes can be reduced most effectively by adding intensive blood pressure management and lipid control to glycemic regulation. Unfortunately, the challenges healthcare professionals and patients must overcome to ensure treatment success continue to persist. The drug armamentarium has grown in recent years and now provides the physician with treatment regimens that can be tailored to the individual patient's needs and, thus, provides the tools necessary for a lifetime of glycemic control. The challenges that still face healthcare professionals and the advantages and disadvantages of each class of drug will be discussed.
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