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Strategies for the Practical Management of Type 2 Diabetes

Strategies for the Practical Management of Type 2 Diabetes. Aaron Vinik MD, PhD, FCP, MACP, FACE Murray Waitzer Endowed Chair for Diabetes Research Professor of Medicine, Neurobiology and Pathology The Leonard Strelitz, Diabetes and Metabolic Institute

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Strategies for the Practical Management of Type 2 Diabetes

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  1. Strategies for the Practical Management of Type 2 Diabetes Aaron Vinik MD, PhD, FCP, MACP, FACE Murray Waitzer Endowed Chair for Diabetes Research Professor of Medicine, Neurobiology and Pathology The Leonard Strelitz, Diabetes and Metabolic Institute Neuroendocrine Unit, Norfolk VA 23510 • 3/20/16

  2. Contents • Physiology and pathophysiology of type 2 diabetes • Role of Incretins, DPP IV inhibitors, SGLT 2, inhibitors, • How intensively should we treat and are there problems

  3. Too Many Notes: Up and Down the Scales of Diabetic Therapy • Aaron Vinik MD Guest Editor; • Clinical Therapeutics 29: 1227, 2007

  4. “All who drink of this treatment recover in a short time. Except for those who died. Thus, it appears to be effective in all but the incurable cases.” Galen

  5. Patient-Centered Care

  6. Modern Antihyperglycemic Agents

  7. Failure to Achieve Goals • Complex disease; Difficult lifestyle • Natural progression of disease • Low health literacy/ lower social strata • Multiple medications – costs associated • Lack of suppression of Glucagon • Drug side effects • Weight gain • Hypoglycemia • GI side effects • Change in blood pressure • Cardiovascular safety • Restricted use (Elderly, CHF, Renal Impairment) • Failure of health professionals

  8. “I don’t want to make the wrong mistake.” Y Berra

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