Management of Type 2 DiabetesMellitus

Abstract

Type 2 diabetes mellitus is a complex metabolic disease with complex derangements of metabolic pathways that are involved in the glucose metabolism in different organs: the liver, muscles, pancreas, the gut, kidneys, fat cells and the brain. The objectives of the treatment of Type 2 diabetes mellitus are to reverse the underlying eight pathophysiologies called the ‘ominous octet’, achieve glycaemic control, control comorbidities and prevent or reduce the chronic complications. Lifestyle management and pharmacotherapy remain the mainstay of treatment of Type 2 diabetes mellitus. The development of the newer oral hypoglycaemic agents such as the sodium-glucose transporters 2 receptor inhibitors, the dipeptidyl peptidase 4 inhibitors and the injectables such as the glucagon-like peptide 1 receptor agonists and the analogue insulin in the last decades has provided broad and extended treatment options to achieve the treatment objectives. The recent announcement of the novel combinational peptides, Tirzapatide and Rezatrutide, promises a new era of pharmacotherapy for T2DM.