Adjusting the use of glucose-lowering agents in the real-world clinical management of people with type 2 diabetes: A narrative review
Document Type
Article
Publication Date
5-1-2023
Abstract
Despite the availability of new treatment classes, glycaemic control in patients with diabetes remains suboptimal globally. The latter is associated with high risk of premature mortality related to diabetes and its microvascular and macrovascular complications. Practice guidelines typically focus on glycated haemoglobin < 7.0% as a therapeutic goal in type 2 diabetes (T2D). Reducing glycated haemoglobin has been proven to reduce the risk of these complications while early attainment of glycaemic goal can have a legacy effect in later life. Both glucocentric and cardiorenal-centric treatment strategies have complementary effects in reducing the trajectory of cardiorenal diseases. In real-word settings, implementation of practice guidelines developed in the USA and Europe may not be applicable to regions such as Asia, where differences in epidemiology, patient phenotypes, cultures, resource availability, and treatment affordability are important considerations. In the present review, we discuss the need to use a pragmatic, albeit evidence-based approach, to combine glucocentric and cardiorenal risk reduction strategies to improve the outcomes in patients with T2D, with particular relevance to Asia Pacific.
Keywords
Asia Pacific, Glucocentric, Glycaemic control, Cardiorenal, Major adverse cardiovascular events, Chronic kidney disease, Heart failure, Mortality, Real-world evidence
Divisions
medicinedept
Funders
Servier
Publication Title
Diabetes Therapy
Volume
14
Issue
5
Publisher
Springer Heidelberg
Publisher Location
TIERGARTENSTRASSE 17, D-69121 HEIDELBERG, GERMANY