Treating Type 2 Diabetes Mellitus
There are numerous medications available to achieve glycemic targets. While many organizations recommend use of metformin at the time of diagnosis of type 2 diabetes, lifestyle modification remains an essential component of any treatment regimen. If this alone is recommended as initial treatment, then medications should be started within 3 months if A1C targets are
Because of the decline in beta cell function over time, many patients with type 2 diabetes eventually require insulin therapy. Oral hypoglycemic agents lose efficacy over time in part due to loss of insulin secretory capacity of the beta cell. In the UKPDS, for example, 50% of the participants originally controlled with monotherapy needed the
MetforminMetformin is the only biguanide currently in use. Although available internationally for decades, metformin was not approved for clinical use in the United States until 1995. Metformin is the only available medication of this class in the United States, as its predecessor phenformin was discontinued due to its high association with lactic acidosis in 1976.
Prevalence of Diabetes Mellitus (DM) Type 2Diabetes currently affects 23.6 million people in the United States, or 7.8% of the population, and 246 million people worldwide. Approximately 90–95% of those affected have type 2 diabetes (DM2). Diabetes is the fifth leading cause of death by disease in the United States and was estimated to cost