Although hard end-point studies are somewhat sparse in diabetology, little doubt exists that near-normal blood glucose levels are beneficial, relieving symptoms and preventing long-term vascular complications. Guidelines are legion, and treatment goals are becoming increasingly ambitious. For example, the latest IDF guidelines for the treatment of type 2 diabetes  aim for HbA1c levels lower than 6.5%. Since this goal is rarely achieved through lifestyle measures alone, oral antidiabetic agents are usually required. Initially, monotherapy is commenced with the most appropriate drug, based on the clinical and biochemical profile of the patient, and in the light of safety considerations. For most patients, drugs from different classes are required in varying combinations, insulin being ultimately necessary in many patients. Current guidelines recommend metformin and sulphonylureas as first-line therapy.
Other regimens may be equally effective or even more so. However, comparative studies are sparse. With very prevalent diseases such as type 2 diabetes, pharmacoeconomics become extremely important. Thus, both the economy of society at large and the economy of the individual patient must be taken into account when choosing drug therapy. Safety issues remain important since treatment will often be continued for many years or even life-long, during which time complications, for example, nephropathy or cardiovascular disease, that may alter the safety profile of certain drugs may develop.
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Diabetes is a disease that affects the way your body uses food. Normally, your body converts sugars, starches and other foods into a form of sugar called glucose. Your body uses glucose for fuel. The cells receive the glucose through the bloodstream. They then use insulin a hormone made by the pancreas to absorb the glucose, convert it into energy, and either use it or store it for later use. Learn more...