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Journal ArticleDOI

1.8 Initial Triple Combination Therapy is Superior to Stepwise Add-On Conventional Therapy in Newly Diagnosed T2DM (72-OR)

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TLDR
In UKPDS stepwise addition of metformin, sulfonylurea, and basal insulin reduced microvascular complications, but A1c rose progressively to > 8.5% and ~ 65% of individuals required insulin therapy aft er 10.5 years, still the most frequently employed therapeutic recommendation in the US and other countries.
Abstract
Background: In UKPDS stepwise addition of metformin, sulfonylurea, and basal insulin reduced microvascular complications, but A1c rose progressively to > 8.5% and ~ 65% of individuals required insulin therapy aft er 10.5 years. Yet metformin, add SU, add insulin remains the most frequently employed therapeutic recommendation in the US and other countries.

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Pathophysiologic approach to therapy in patients with newly diagnosed type 2 diabetes

TL;DR: It is believed that the most important consideration is to select antidiabetes agents that correct specific pathophysiologic disturbances present in T2DM and that have complementary mechanisms of action.
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Glycemic Goals in Diabetes: Trade-off Between Glycemic Control and Iatrogenic Hypoglycemia

TL;DR: A reasonable individualized glycemic goal is the lowest A1C that does not cause severe hypoglycemia and preserves awareness of hypoglyCEmia, preferably with little or no symptomatic or even asymptomatic hyp glucosecemia, at a given stage in the evolution of the individual's diabetes.
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Pathophysiological and Pharmacological Rationale for the Use of Exenatide Once Weekly in Patients with Type 2 Diabetes

TL;DR: Exenatide QW may be particularly well suited to patients who desire the benefits associated with glucagon-like peptide-1 receptor agonists, including significant glycemic control, low risk of hypoglycemia, and moderate weight loss, but prefer the convenience of once-weekly dosing.
Journal ArticleDOI

Intensive therapy in newly diagnosed type 2 diabetes: results of a 6-year randomized trial.

TL;DR: Early intensive treatment at the time of type 2 diabetes diagnosis—initial short-term insulin treatment followed by either insulin-based or intensive oral hypoglycemic–based therapy—stabilizes β-cell function for at least 6 years.
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Evidence-Based Practice Use of Incretin-Based Therapy in the Natural History of Diabetes

TL;DR: An evidence-based practice approach is taken in discussing the importance of aggressive treatment for diabetes, the principles of incretin physiology and pathophysiology, use of glucagon-like peptide-1 receptor agonists and dipeptidyl peptidase-4 inhibitors, and patient types and contexts where incretIn therapy has been found beneficial, from metabolic syndrome to overt diabetes.
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