Blood glucose regulation as the mainstay for T2DM therapy : avoid glucotoxicity

manaf, asman (2010) Blood glucose regulation as the mainstay for T2DM therapy : avoid glucotoxicity. (Unpublished)

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Abstract

Management of hyperglycemia, the hallmark of type 2 diabetes mellitus ( T2DM ), has historically taken center stage in the treatment of this disease. Maintaining glycaemic levels as close to the normal range as possible has been demonstrated to have a powerful beneficial impact on tissue damages. More intensive treatment strategies have likewise been demonstrated to reduce complications. Although, therapies directed at other coincident features such as the components of metabolic syndrome and insulin resistance, have also been a major focus of treatment. Decreased insulin sensitivity and impared insulin secretion are the two major genetic abnormalities in T2DM. The occurrence of hyperglycemia has been identified as the consequence of the two factors. Improving insulin resistances and insulin deficiencies will be the best rational treatment in order to get normal blood glucose levels. More than one medication is usually necessary for the majority of diabetic patients overtime. In general, antihyperglycaemic drugs with different mechanism of action were needed to have the greatest synergy . It is reasonable to consider antihyperglycaemic agent with double salutary effect : improving both insulin deficiency and insulin resistance. Glucotoxicity, either chronic or acute postprandial must be avoided to fight the complication. Keywords : insulin resistance and insulin deficiency, glucotoxicity, complications

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