Managing recent-onset diabetes: Choosing durable, well-tolerated therapies and understanding the role of incretin-based therapies

Abstract

Management of recent-onset diabetes offers osteopathic physi¬cians the opportunity to work with patients to set treatment goals and expectations for this progressive yet manageable disease, as well as inter vene ear l y to reduce the risk of diabetes-related complications. Starting effective therapy early-and intensifying therapy appropriately-to achieve and maintain glycemic goals has been shown to reduce microvascular risks and produce legacy effects that may have macrovascular benefts. Metformin remains a cornerstone of therapy for those patients who can tolerate it. Early combination therapy that is well toler-ated reduces risks of hypoglycemia or unwanted weight gain, improves patient adherence, and addresses the multifactoral pathophysiology of even recent-onset diabetes. Incretin-based therapies have been shown to be effective across the spectrum of type 2 diabetes mellitus, including recent-onset diabetes. The present article reviews the use of incretin-based therapies early in the disease process of type 2 diabetes mellitus. © 2014 American Osteopathic Association.