Strategies for the Management of Type 2 Diabetes

The approach to the management of hyperglycaemia in type 2 diabetes has become increasingly complex with a widening armamentarium of available antihyperglycaemic agents. It is well recognized that several agents have additional benefits (outside of glucose control), for example, on weight management and on cardiovascular and renal outcomes. Recent cardiovascular outcome trial data has had an impact on treatment algorithms. This chapter looks at strategies for deploying the various agents. The initiation of therapy, intensification of therapy, and combination of agents is discussed. The choice of agent in particular circumstances, in cardiovascular disease, renal disease, and hepatic impairment is discussed. Successful management requires a patient-centred approach with careful consideration of the risks and benefits of the treatment options.