Options for the Treatment of Type 2 Diabetes

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Diabetes mellitus is a metabolic disorder affecting the body’s ability to take up glucose into the tissues. There are two main classifications; Type 1 is known as insulin dependent, meaning that the patient’s body no longer produces insulin to help in the uptake of glucose. Type 2 is known as non-insulin dependent, these patients usually have two problems; insulin resistance, the insulin they produce does not work properly and β-cell impairment, their body does not produce enough insulin.2 In 2008 a study showed that of 24 million patients diagnosed with Type 2 diabetes in the United States, 40% of them were 65 years of age or older.1 Patients diagnosed with diabetes have elevated HbA1C levels of 6.5% or higher. The American Diabetes Association recommends a target of < 7% for most patients3 with diabetes to be considered controlled. Type 2 Diabetes patients usually begin with monotherapy oral medication, such as Metformin along with diet and exercise to decrease blood glucose levels and HbA1C levels. Unfortunately, monotherapy is not effective in many patients and they soon add a second therapy. A sulfonylurea, such as Glyburide, is a second-line drug in the treatment of diabetes because it “enhances insulin secretion”3 unlike metformin which “increases insulin sensitivity.”3 A study published in The Journal of Clinical Endocrinology & Metabolism compared the effects of metformin monotherapy, glyburide monotherapy and glyburide-metformin therapy in 486 patients whose

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