From the Guidelines
The biochemical approach to managing diabetes should prioritize a person-centered shared decision-making approach, considering the effects of glucose-lowering medications on cardiovascular, kidney, weight, and other relevant comorbidities, as well as individual preferences 1. When managing diabetes, it is essential to control blood glucose levels through a combination of medication, lifestyle changes, and monitoring.
Key Considerations
- For type 1 diabetes, insulin therapy is crucial, with various options available, including rapid-acting insulins, intermediate-acting insulins, long-acting insulins, and ultra-rapid insulins.
- For type 2 diabetes, management typically begins with metformin, which reduces hepatic glucose production and improves insulin sensitivity, with additional medications considered based on individual needs and preferences.
Medication Options
- Sulfonylureas, which stimulate insulin secretion
- DPP-4 inhibitors
- SGLT-2 inhibitors, which increase glucose excretion through urine
- GLP-1 receptor agonists, which enhance insulin secretion and reduce glucagon
- Thiazolidinediones, which improve insulin sensitivity
Lifestyle Changes
- Portion control and carbohydrate counting are essential for managing blood glucose levels, with a focus on nutrient-dense, high-fiber foods and avoidance of added sugars and saturated fats 1.
- Regular physical activity and monitoring of blood glucose levels are also crucial for effective diabetes management.
Monitoring and Targets
- Regular blood glucose monitoring is vital, with target fasting levels of 80-130 mg/dL and post-meal levels below 180 mg/dL.
- By addressing the underlying metabolic abnormalities in diabetes, including insufficient insulin production, insulin resistance, excessive hepatic glucose production, and impaired incretin effect, this approach can help prevent complications like neuropathy, nephropathy, retinopathy, and cardiovascular disease.
From the FDA Drug Label
The FDA drug label does not answer the question.
From the Research
Biochemical Approach to Managing Diabetes
The biochemical approach to managing diabetes involves understanding the underlying chemical reactions and processes that occur within the body. As stated in 2, biological reactions are governed by the same rules as any other chemical reaction, and a firm understanding of the fundamentals of chemistry is invaluable in biochemistry.
Key Aspects of Biochemical Approach
- Chemical principles: Understanding the basic principles of chemistry and how they apply to biological systems is crucial in managing diabetes 2.
- Metformin therapy: Metformin monotherapy with lifestyle changes has been shown to improve anthropometric parameters, blood pressure, blood glucose, and lipid profile in patients with type 2 diabetes 3.
- Insulin sensitivity: Metformin treatment has been found to increase sensitivity to insulin, resulting in improved glucose metabolism 4.
- Vascular reactivity: Metformin has been shown to improve carotid artery diameter and blood flow in patients with type 2 diabetes, whereas glimepiride does not have this effect 5.
Biochemical Basis of Disease
The biochemical basis of disease, including diabetes, is complex and involves multiple factors such as genetic, environmental, and lifestyle factors 6. Understanding the biochemical causes of disease is essential in developing effective treatment strategies.
Treatment Strategies
- Metformin: Metformin is a commonly used medication for managing type 2 diabetes, and its effects on glucose and lipid metabolism, as well as blood pressure, have been well-documented 3, 4, 5.
- Lifestyle changes: Lifestyle changes, such as diet and exercise, are also crucial in managing diabetes and can be used in conjunction with metformin therapy 3.