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Practical combination therapy based on pathophysiology of type 2 diabetes

Authors Levin PA

Received 25 March 2016

Accepted for publication 30 April 2016

Published 31 October 2016 Volume 2016:9 Pages 355—369

DOI https://doi.org/10.2147/DMSO.S109216

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Lucy Goodman

Peer reviewer comments 2

Editor who approved publication: Professor Ming-Hui Zou


Philip A Levin

MODEL Clinical Research, Endocrinology, Department of Medicine, Greater Baltimore Medical Center, Baltimore, MD, USA

Abstract: Type 2 diabetes is a complex, chronic, and progressive condition that often necessitates the use of multiple medications to achieve glycemic goals. Clinical guidelines generally recommend intensifying pharmacotherapy if glycemic goals are not achieved after 3 months of treatment. However, for many patients with type 2 diabetes, treatment intensification is delayed or does not occur. Initiating combination therapy early in the disease course has the potential to delay disease progression and improve patient outcomes. Guidelines generally provide a list of agents that may be used in combination regimens and emphasize individualization of treatment. The purpose of this review is to discuss the rationale for combination therapy, considering treatment effects on pathophysiologic aspects of type 2 diabetes and individual drug profiles. The combination of newer antidiabetes therapies with complementary mechanisms of action provides the opportunity to target multiple sites of tissue, organ, and cellular dysfunction.

Keywords: type 2 diabetes, combination therapy, oral antidiabetes drugs, insulin

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