Management of type 2 diabetes: update on new pharmacological options.

The value of intensive control of blood glucose levels has been clearly established. Data from the UKPDS demonstrated that improving glycemic control will reduce the risk of microvascular complications of type 2 diabetes, such as diabetic retinopathy, nephropathy, and peripheral neuropathy. Further, the metformin study in overweight patients and the epidemiological analysis of the study both demonstrated a reduction in macrovascular complications and mortality related to improved glycemic control. These findings should enhance awareness among both patients and physicians of the dangers of uncontrolled hyperglycemia and the need for early diagnosis and aggressive treatment for patients with type 2 diabetes. Optimal management of type 2 diabetes most often requires a combination of glucose-lowering medications to achieve glycemic control. Current guidelines for combination therapy advise the use of agents with differing and complementary mechanisms of action in order to maximize therapeutic activity and reduce toxicity. Earlier introduction of combination therapy is increasingly being recommended. The new glyburide/metformin combination medication may facilitate earlier, more appropriate and more effective treatment for patients with type 2 diabetes.