Type 2 diabetes - How new insights, new drugs are changing clinical practice

In 1997, the American Diabetes Association recommended a normal fasting blo od glucose of <126 mg/dL as the criteria for diagnosis of type 2 diabetes. Since then, new data have suggested that post-prandial glucose may have a s tronger correlation with cardiovascular disease than fasting blood glucose. Two trials, the DCCT and UKPDS, provided evidence of the relationship betw een hyperglycemia and long-term diabetic complications. Preventing short-te rm complications, such as cognitive decline, is a more immediate goal and l ess well-studied. Type 2 diabetes is understood to result most often from i nsulin resistance and insulin deficiency. New classes of drugs offer expand ed therapeutic options for managing this dual metabolic defect. These drugs have invalidated the former therapeutic paradigm of diet, sulfonylureas, a nd then insulin therapy.