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Type 2 diabetes treatment strategies for optimal care vendor,design s iv 9850,type 2 diabetes what can happen next - Easy Way

Is the increased total mortality and sudden death risk associated with the intensive glycemic treatment strategy (ACCORD – VADT) linked to hypoglycemia ?
Although metformin is first-line therapy for patients with type 2 diabetes, glycemic control fails with metformin alone in many patients.
Bernard Charbonell (University of Nantes, France) discussed new options in diabetes management.


An open-label randomized controlled trial was conducted, which compared add-on exenatide with add-on glimepiride in patients who had failed to achieve glycemic control with metformin alone. We recognised that there was underlying moderate-severe insulin resistance affecting muscle and the liver, and this, coupled with beta cell failure, formed the classical triumvirate (1). The insulin resistance in muscle primarily was responsible for the excessive postprandially rise in plasma glucose concentration, while insulin resistance in the liver, in combination with accelerated gluconeogenesis, resulted in an excessive rate of hepatic glucose production which led to an increase in the fasting plasma glucose concentration (2-4).





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