RACGP
Australian Family Physician
Australian Family Physician

Advertising

Volume 38, Issue 1, January-February 2009

Controversies in type 2 diabetes An update

Bu B Yeap
Download article
Cite this article    BIBTEX    REFER    RIS

Background
Controversy has emerged concerning the risks associated with glitazone therapy in type 2 diabetes, specifically bone fracture and myocardial infarction. Results from the Action to Control Cardiovascular Risk in Diabetes (ACCORD) study have stimulated debate about appropriate glycated haemoglobin (HbA1c) targets.
Objective
This article examines the context for glitazone therapy in patients with type 2 diabetes, the risks associated with pioglitazone and rosiglitazone, and arguments for targeting HbA1c at the threshold of 7%.
Discussion
Pioglitazone and rosiglitazone can be employed as oral therapy in patients with type 2 diabetes and preserved endogenous insulin secretion. Potential benefits and risks of each agent should be considered. An acceptable initial target for HbA1c is 7%. Lowering HbA1c to 6.5% did not reduce macrovascular complications in patients with type 2 diabetes, but did reduce new or worsening nephropathy. Aggressive therapy aiming to lower HbA1c to <6% in patients with type 2 diabetes at especially high risk of cardiovascular disease may lead to a higher risk of mortality.

Download the PDF for the full article.


Download article PDF

Advertising

Australian Family Physician RACGP

Printed from Australian Family Physician - https://www.racgp.org.au/afp/2009/january-february/controversies-in-type-2-diabetes
© The Australian College of General Practitioners www.racgp.org.au