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. 2013 Aug;36 Suppl 2(Suppl 2):S127-38.
doi: 10.2337/dcS13-2011.

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

Ralph A DeFronzo  1 , Roy Eldor, Muhammad Abdul-Ghani
Affiliations

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

Ralph A DeFronzo et al. Diabetes Care. 2013 Aug.
No abstract available

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Figures

Figure 1
Figure 1
The ominous octet (3) depicting the mechanism and site of action of antidiabetes medications based upon the pathophysiologic disturbances present in T2DM.
Figure 2
Figure 2
Natural history of T2DM. The plasma insulin response depicts the classic Starling’s Curve of the Pancreas. See text for a detailed explanation (7). Upper panel: Insulin-mediated glucose disposal (insulin clamp technique) and mean plasma insulin concentration during OGTT. Lower panel: Mean plasma glucose concentration during OGTT. DIAB, T2DM; Hi, high; Lo, low; OB, obese.
Figure 3
Figure 3
Insulin secretion/insulin resistance (disposition) index (ΔI/ΔG ÷ IR) during OGTT in individuals with NGT, IGT, and T2DM as a function of the 2-h plasma glucose (PG) concentration in lean and obese subjects (–12).
Figure 4
Figure 4
The effect of sulfonylurea (glibenclamide = glyburide) and metformin therapy on the plasma HbA1c concentration in newly diagnosed T2DM subjects in UKPDS. Conventionally treated diabetic subjects received diet plus exercise therapy (113,114).
Figure 5
Figure 5
Durability of glycemic control with sulfonylureas. Summary of studies examining the effect of sulfonylurea treatment versus placebo or versus active comparator on HbA1c in T2DM. See text for a more detailed discussion (,,–,,,–127,131,132).
Figure 6
Figure 6
Durability of glycemic control with TZDs. Summary of studies examining the effect of TZDs versus placebo or versus active comparator on HbA1c in T2DM subjects. See text for a more detailed discussion (,,–92). Pio, pioglitazone; Rosi, rosiglitazone.
Figure 7
Figure 7
A single dose of liraglutide (Lira) (7.5 μg/kg or 0.75 mg for 100-kg person) administered acutely completely restores β-cell sensitivity to glucose using the graded glucose infusion technique to evaluate β-cell function (86).
See this image and copyright information in PMC

References

    1. Nathan DM, Buse JB, Davidson MB, et al. American Diabetes Association. European Association for Study of Diabetes Medical management of hyperglycemia in type 2 diabetes: a consensus algorithm for the initiation and adjustment of therapy: a consensus statement of the American Diabetes Association and the European Association for the Study of Diabetes. Diabetes Care 2009;32:193–203 - PMC - PubMed
    1. Schernthaner G, Barnett AH, Betteridge DJ, et al. Is the ADA/EASD algorithm for the management of type 2 diabetes (January 2009) based on evidence or opinion? A critical analysis. Diabetologia 2010;53:1258–1269 - PMC - PubMed
    1. Defronzo RA. Banting Lecture. From the triumvirate to the ominous octet: a new paradigm for the treatment of type 2 diabetes mellitus. Diabetes 2009;58:773–795 - PMC - PubMed
    1. Pozzilli P, Leslie RD, Chan J, et al. The A1C and ABCD of glycaemia management in type 2 diabetes: a physician’s personalized approach. Diabetes Metab Res Rev 2010;26:239–244 - PubMed
    1. Inzucchi SE, Bergenstal RM, Buse JB, et al. American Diabetes Association (ADA) European Association for the Study of Diabetes (EASD) Management of hyperglycemia in type 2 diabetes: a patient-centered approach: position statement of the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD). Diabetes Care 2012;35:1364–1379 - PMC - PubMed

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