The last decade has seen the advent of new medications for
lowering blood glucose levels. These medications also exhibit a remarkable
capacity to alleviate cardiovascular risk factors. This comprehensive review
highlights the evolving landscape of pharmacotherapy in diabetes, the drugs
currently available for treating diabetes, their effectiveness and efficacy,
the impact on target organs, and side effects. This review also provides an
overview of oral and injectable non-insulin medications used to improve blood
glucose levels. This work also provides insights that can support the
customization of treatment strategies. We delve into the concept of precision
medicine and explore the role of older drugs in patient management.
Furthermore, we present a proposal for a groundbreaking approach to the
treatment of type 2 diabetes, with an emphasis on striving for a cure for the
disease. The treatment of type 2 diabetes (T2D) necessitates a multifaceted
approach that combines behavioral and pharmacological interventions to mitigate
complications and sustain a high quality of life. Treatment encompasses the
management of glucose levels, weight, cardiovascular risk factors,
comorbidities, and associated complications through medication and lifestyle
adjustments. Metformin, a standard in diabetes management, continues to serve
as the primary, first-line oral treatment across all age groups due to its
efficacy, versatility in combination therapy, and cost-effectiveness.
Glucagon-like peptide-1 receptor agonists (GLP-1 RA) offer notable benefits for
HbA1c and weight reduction, with significant cardiovascular benefits.
Sodium-glucose cotransporter inhibitors (SGLT-2i) lower glucose levels
independently of insulin while conferring notable benefits for cardiovascular,
renal, and heart-failure outcomes. Combined therapies emphasizing early and
sustained glycemic control are promising options for diabetes management. As
insulin therapy remains pivotal, metformin and non-insulin agents such as GLP-1
RA and SGLT-2i offer compelling options. Notably, exciting novel treatments
like the dual GLP-1/ glucose-dependent insulinotropic polypeptide (GIP) agonist
show promise for substantially reducing glycated hemoglobin and body weight.
Recent studies have highlighted a clear correlation between reducing HbA1c to
less than 6.5% and a significant decrease in microvascular and macrovascular
complications. Studies also suggest the potential benefits of primary combined
therapy for glycemic management in diabetes compared to monotherapy with metformin
across a wide range of baseline HbA1c levels. The most effective way to manage
diabetes is to treat it with a combination therapy from the time of initial
diagnosis. To help medical staff choose the ideal drug combination for each
patient, the National Diabetes Council in Israel developed a calculator that
recommends the most appropriate combination therapy based on the patient’s BMI,
HbA1c levels, and risk for ischemic heart disease, stroke, renal function, and
heart failure. Along with the most appropriate drug treatment, a healthy
lifestyle is extremely important.
Author(s)details:-
Roni Weinberg Sibony
Faculty of Medicine, Ben-Gurion University, Beer Sheva 8443944, Israel.
Omri Segev
Faculty of Medicine, Tel Aviv University, Tel Aviv 69978, Israel.
Saar Dor
Faculty of Medicine, Ben-Gurion University, Beer Sheva 8443944, Israel.
Itamar Raz
Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem 9112001,
Israel and Department of Endocrinology and Metabolism, Diabetes Unit, Hadassah
Medical Center, Jerusalem 91240, Israel.
Please See the book
here :- https://doi.org/10.9734/bpi/mria/v4/11972F
No comments:
Post a Comment