What are the new ideas in the treatment of type 2 diabetes

  1. Active rationalized treatment mode instead of traditional treatment mode. The new treatment model is based on the pathophysiological characteristics of different stages of the natural course of type 2 diabetes mellitus and proposes to give drug treatment as early as possible on the basis of lifestyle intervention, early combination of drugs, and appropriate addition of insulin stimulants or insulin according to the degree of islet function decline in different stages.  2, advocate the early combined application of hypoglycemic drugs, combined drugs can reduce hyperglycemia as soon as possible, maximize the protection of B-cell function and delay its decline, can give full play to the synergistic effect between different drugs, so that blood glucose quickly and lastingly reach the standard to reduce the adverse reactions that may result from the excessive dose of their respective drugs. Generally, the joint application of two drugs, if necessary, three drugs, the use of two drugs with the same mechanism of action is not advocated.  3, advocate the early application of insulin, when the HbA1c is greater than 7, 0% should start insulin therapy, UKPDS research results found that the initial diagnosis of diabetes B-cell function only 50% left, and at a rate of 4-5% decline, 10 years later islet function is almost lost. Therefore, the goal of treatment for newly diagnosed or early-stage diabetes should be different from that for advanced diabetes with a long duration of disease. The primary goal of treatment for advanced diabetes is to bring blood glucose up to standard in order to prevent further deterioration of complications; whereas for newly diagnosed diabetes, restoring and protecting B-cell function should be a more important goal. In addition, by relieving glucotoxicity and lipotoxicity, the sensitivity of peripheral tissues to insulin can be improved, which is not only conducive to good control of blood glucose, but also can effectively protect blood vessels and reduce or delay the occurrence of various complications.  4. Pay attention to the attainment of postprandial glucose and the reconstruction of insulin secretion in the first time phase. Early intensive insulin therapy for newly diagnosed or early type 2 diabetes patients can achieve better long-term remission effect.  5. Metformin is widely used in clinical practice, and almost all diabetes guidelines recommend metformin as the first-line drug for the treatment of type 2 diabetes. In the latest version of the 2007 American Diabetes Federation ADA clinical guidelines for diabetes, metformin as the first-line treatment drugs and throughout the treatment.  6, intensive treatment instead of conventional treatment, intensive treatment can effectively protect pancreatic B cells, islet B cells are damaged to rest and repair, so as to restore and improve their own insulin secretion function, can also effectively protect blood vessels, reduce or delay the occurrence of various complications, after active intensive treatment, about 10% of early diabetic patients can stop using oral drugs.