Should we Change our Therapeutic Management of Type 2 Diabetes based on Accumulating Evidence?
In the last two decades, a dramatic shift in the paradigm of management of type 2 diabetes has been settled. Reduction of diabetic complications became the primary target instead of focusing on the mere glycemic control. The tight blood sugar control among type 1 (T1DM) and type 2 (T2DM) diabetes mellitus patients aimed at avoidance of long-term complications of diabetes. In spite of the significant impact of this approach on the incidence of these complications, the outcome is still not satisfactory. The frequent failure to achieve tight blood sugar control and the lack of hypoglycemic agents that are capable to combat the underlying pathogenic mechanisms of diabetic complications underlie this unsatisfactory outcome. These drawbacks are overcome in the newly introduced hypoglycemic agents. In this review, we are going to discuss these mechanisms and highlight the therapeutic value of the early use of these agents instead of the long-standing traditional approach.
