RECENT ADVANCES IN THE TREATMENT OF TYPE-II DIABETES-MELLITUS

Diabetes mellitus needs to be managed early to prevent the onset and p rogression of complications. Diet and exercise may not be sufficient t o achieve and maintain good glycemic control. Currently, no pharmacolo gic agent addresses all of the fundamental abnormalities in the pathog enesis of type II diabetes mellitus. However, the newer agents do not exacerbate the hyperinsulinemia that often occurs with-type II diabete s, and they may help reduce the risk of cardiovascular disease that is associated with high insulin levels. Two of these agents, metformin a nd acarbose, have recently become available in the United States for t he treatment of type II diabetes. With the availability of agents that differ in their mechanisms of action and side effect profiles, regime ns can be individualized to address the variety of pathophysiologic ab normalities in type II diabetes. For this purpose, agents can be used alone or in combination.