Pharmacologic management of the patient with newly diagnosed type 2 diabetes
• Objective: To review appropriate pharmacologic management for patients with newly diagnosed type 2 diabetes. • Methods: Qualitative assessment of the literature. • Results: Intensive control of blood glucose in patients with type 2 diabetes has been shown to reduce the prevalence and incidence of microvascular disease but may not be sufficient to reduce cardiovascular events. Few oral antidiabetic agents have been evaluated for effect on cardiovascular outcomes; however, metformin and acarbose are both associated with reduced morbidity and, in the case of metformin, mortality related to cardiovascular disease. Aggressive management of lipids and blood pressure have also been shown to reduce cardiovascular morbidity and mortality in patients with type 2 diabetes. • Conclusions: In patients early in the course of type 2 diabetes, choice of pharmacologic agent to control blood glucose can often be guided by determination of cardiovascular risk status. Most patients will require combination therapy to control blood glucose, blood pressure, and lipid levels.
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