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Advances in the treatment of type 2 diabetes: Pharmacists Module 3, 2022
Diabetes mellitus (diabetes) is a chronic, complex, metabolic disorder when raised blood levels of glucose occur because the body either cannot produce enough (or any) insulin or cannot effectively use the insulin it produces.
A lack of insulin or the inability of the body’s cells to respond to insulin, leads to high levels of glucose in the blood i.e. hyperglycaemia, which is the clinical indicator of diabetes.
The insulin deficit and resultant hyperglycaemia, if left unchecked over the long term, can cause damage to many of the body’s organs, leading to disabling and life-threatening health complications such as:
- Macrovascular complications – Myocardial infarction, stroke and lower limb amputation
- Microvascular complications – Nerve damage (neuropathy), kidney damage (nephropathy), eye disease, mainly affecting the retina (retinopathy), resulting in visual loss or even blindness
- Autonomic dysfunction
- Erectile dysfunction
However, if appropriate management of diabetes is achieved, these serious complications can be delayed or even prevented altogether. The results of several clinical trials have demonstrated the short-term and long-term benefits of improving blood glucose control in delaying the onset, and reducing the severity, of diabetes-related complications – particularly retinopathy, nephropathy, neuropathy and cardiovascular disease, as well as mortality.
Several new medicines have become available for the treatment of type 2 diabetes, some of which have been shown to play a role in managing blood glucose levels as well as in preventing and managing the complications associated with type 2 diabetes.
Recent guidelines recommend a patient-centred approach to choosing pharmacologic therapy for type 2 diabetes. Patients may prefer one treatment over another because of ease of use, tolerability profile and affordability.
The pharmacist is in the position to discuss the various medicines that are available and in collaboration with their prescriber, help the patient find the best match in terms of glycaemic efficacy, cardiovascular risk, side effect profile, patient preference and cost.
This module discusses these recent developments in the treatment of type 2 diabetes.
