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New Approaches to the Treatment of Type 2 Diabetes Mellitus

Intensive Insulin Therapy in Type 2 Diabetes and Development or Progression of Microvascular Complications

Development or Progression of Complication (%)

 

Retinopathy:

Primary

Prevention

Retinopathy:

Secondary Intervention

Nephropathy:

Primary Prevention

Nephropathy:

Secondary Intervention

Intensive

Therapy (Mean HbAlc 7.1%)

8

19

8

12

Conventional

Therapy (Mean HbAlc 9.4%)

32

44

28

32

Type 2 Diabetes Mellitus

· Pathophysiology

Strong genetic component: 90% concordance in identical twins

Multiple genes presumed

Combined defects in insulin secretion and insulin action: insulin sensitivity predicts disease

Obesity major risk factor

·Age of Onset/Predictors

Majority > age 40

Gestational diabetes, obesity are predictors diabetis