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| Topic: |
diabetes (dm) |
| Title: |
Insulin as a First-Line Therapy in Type 2 Diabetes: Should the Use of Sulfonylureas be Halted?. |
| Author: |
Standl, E.; Schnell, O. |
| Source: |
Diabetes Care. 31(Suppl 2): S136-S139. February 2008. |
| Abstract: |
This article, from a special supplement of Diabetes Care magazine that reports the proceedings of the 1st World Congress on Controversies in Diabetes, Obesity, and Hypertension (CODHy) held in Berlin in 2006, considers the use of insulin as a first-line therapy in patients with type 2 diabetes, supplanting the use of sulfonylurea compounds. The authors explore the advantages and drawbacks to each therapy, focusing on the evidence base, the limitations of present information, other treatment options, pathogenesis, and the impact of specific drug regimens on cardiovascular disease (CVD). The authors conclude that it is not easy to recommend a simple treatment regimen for patients with type 2 diabetes, and the complexities are not only based on whether or not insulin should be a first-line therapy. They stress that appropriate therapy of type 2 diabetes needs to be highly individualized, taking contraindications and potential downsides of treatment options into account and trying to define and target the leading pathogenetic defects behind the prevailing metabolic phenotype. Cost considerations must be figured into the decision. A patient care algorithm for the management of hyperglycemia in type 2 diabetes is presented. 1 figure. 23 references. |
| Format: |
Journal Article |
| Language: |
English. |
| Major Keywords: |
Diabetes Mellitus. Type 2 Diabetes. Oral Hypoglycemic Agents. Insulin. Administration and Dosage. Drug Therapy. Hypoglycemia. Prevention. Patient Care Management. Patient Selection. |
| Minor Keywords: |
Drug Effects. Complications. Pathophysiology. Cardiovascular Diseases. Patient Compliance. Morbidity. Postprandial Hyperglycemia. Costs. |
| Publication Number: |
DMJA13325 |
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