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Treatment with Oral Drugs

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Diabetes. Epidemiology, Genetics, Pathogenesis, Diagnosis, Prevention, and Treatment

Part of the book series: Endocrinology ((ENDOCR))

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Abstract

Till the turn of the century, treatment of hyperglycemia in Type 2 diabetes was limited to two main classes of oral agents: sulfonylureas and biguanides. In the meantime, better understanding of the pathophysiology of hyperglycemia in Type 2 diabetes has been gained and the identification of several pathogenitic mechanisms has enabled moving from serendipitous discovery – as for sulfonylureas and metformin – to the development of agents with more targeted modes of action. Current guidelines concur in recommending metformin at diagnosis of diabetes. Selection of the second drug therapy should be made on the basis of an educated process tacking into consideration efficacy, risk of hypoglycemia, effect on body weight, costs of different drugs, as well as patient’s characteristics. With more clinical data generated, other features of the available oral agents should be taken into account such as durability, predominant effect on fasting vs. postprandial glucose, as well effects beyond their glucose lowering capacity.

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Authors and Affiliations

  1. Department of Clinical & Experimental Medicine, Section of Metabolic Diseases & Diabetes, University of Pisa, Pisa, Italy

    Cristina Bianchi, Giuseppe Daniele, Angela Dardano & Stefano Del Prato

Authors
  1. Cristina Bianchi
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  2. Giuseppe Daniele
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  3. Angela Dardano
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  4. Stefano Del Prato
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Corresponding author

Correspondence to Stefano Del Prato .

Editor information

Editors and Affiliations

  1. Endocrinology, Diabetes and Metabolism, University of Verona, Verona, Italy

    Enzo Bonora

  2. Diabetes Division, UTHSCSA, San Antonio, Texas, USA

    Ralph DeFronzo

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Bianchi, C., Daniele, G., Dardano, A., Del Prato, S. (2018). Treatment with Oral Drugs. In: Bonora, E., DeFronzo, R. (eds) Diabetes. Epidemiology, Genetics, Pathogenesis, Diagnosis, Prevention, and Treatment. Endocrinology. Springer, Cham. https://doi.org/10.1007/978-3-319-27317-4_19-1

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  • DOI: https://doi.org/10.1007/978-3-319-27317-4_19-1

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-27317-4

  • Online ISBN: 978-3-319-27317-4

  • eBook Packages: Springer Reference MedicineReference Module Medicine

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