Fast Five Quiz: How Well Do You Know the Risk Factors and Treatment Indications for Type 2 Diabetes Mellitus?

Romesh Khardori, MD, PhD


January 21, 2022

An international panel of experts has advocated for a paradigm shift in the treatment of type 2 DM, suggesting that weight loss be the primary initial goal, followed by glucose control. The authors state that a loss of 15% or more of body weight can have a disease-modifying effect in type 2 DM, an outcome that is unattainable by any other glucose-lowering intervention. Additionally, weight loss in this population exerts benefits that extend beyond glycemic control and improves risk factors for cardiometabolic disease and quality of life.

Aggressive glucose lowering may not be the best strategy in all patients, and individual risk stratification is highly recommended. In patients with advanced type 2 DM who are at high risk for cardiovascular disease, lowering A1c to 6% or lower may increase the risk for cardiovascular events.

Data from the United Kingdom Prospective Diabetes Study show that microvascular complications (primarily indicated by the need for laser photocoagulation of retinal lesions) are reduced by 25% when mean A1c is 7%, compared with 7.9%. The study also showed that metformin reduces macrovascular risk in patients who are obese.

Learn more about treatment for type 2 DM.


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