Sano Hironari, Tajima Naoko
Division of Diabetes,Metabolism and Endocrinology, Department of Internal Medicine, Jikei University School of Medicine.
Nihon Rinsho. 2008 Oct;66(10):2027-32.
The management of diabetes has changed recently with the early intervention, including diet, exercise, various pharmacological agents and education. In this review, we have provided current evidences of early intervention in various treatments. For example, sulfonylureas, metformin, alpha-glucosidase inhibitors, pioglitazone and glinides appear to be some of the drugs of choice to start with early pharmacological treatment when type 2 diabetic patients continue to have hyperglycemia despite diet and exercise. Clinical studies have shown that insulin therapy should be started sooner at an early stage in the natural progression of the diabetes. Moreover, recent data have demonstrated that treatment with early intervention of lifestyle adjustments as well as some pharmacological agents resulted in greater improvement of glycemic control. Further studies are expected to show the best point of intervention during diabetic course in preventing from progression of diabetic stage and diabetic complications.
