Optimizing combination treatment in the management of type 2 diabetes

• Main Authors: Giuseppe Derosa, Salvadeo Sibilla
• Format: Article
• Language: English
• Published: Dove Medical Press 2007-11-01
• Series: Vascular Health and Risk Management
• Online Access: https://www.dovepress.com/optimizing-combination-treatment-in-the-management-of-type-2-diabetes-peer-reviewed-article-VHRM

Giuseppe Derosa, Salvadeo SibillaDepartment of Internal Medicine and Therapeutics University of Pavia, Pavia, ItalyAbstract: Obtaining the suggested glycemic control is the most important achievement in order to prevent cardiovascular complications in patients with type 2 diabetes. Monotherapy often fails after a period of treatment, so that multiple drugs are needed to achieve effective glycemic control. A number of oral glucose lowering drugs is now available such as metformin, sulfonylureas, non-sulfonylureas secretagogues (metiglinides derivatives), alpha-glucosidases inhibitors, and the newest agent: thiazolidinediones (TZD). The possible associations of oral glucose lowering drugs for optimal treatment of type 2 diabetes are briefly reviewed. In particular, the effects of different classes of drugs on cardiovascular risk factors (and particular hypertension and dyslipidemia) and well recognized cardiovascular disease markers in type 2 diabetes are analyzed: in this context TZD appear the more innovative drugs and have been shown to play a key role in the management of hypertension, dyslipidemia, inflammation and endothelial disfunction in diabetic patients. The possible adverse effects derived from the association of different drug classes are also considered.Keywords: type 2 diabetes, combination therapy, cardiovascular risk factors