Clinical features and treatment of type 2 diabetes include medications such as metformin. Step 2: Use two types of drugs. Two to three months after lifestyle intervention plus oral antidiabetic drug (OAD) therapy, if blood glucose has not yet reached standard levels, adding basal insulin is the most effective treatment: usually pre-dinner short-acting or fast-acting insulin can be added to reduce postprandial blood glucose fluctuations. The combination therapy of basal insulin and starting antidiabetic drugs is the most effective choice and runs through various steps of diabetes treatment. If HbA1c is close to the target (<8.0%), three types of drugs such as sulfonylureas or thiazolidinediones (TZDs) can be considered. However, because this method is expensive and has low efficacy, it should not be a first choice. Step 3: If after 2 to 3 months of step 2 treatment, blood glucose has not been controlled, the treatment strategy needs adjustment.
Chinese type 2 diabetes patients have their own characteristics; treatment should not copy foreign guidelines or consensus. Treatment modalities should be used based on the characteristics of Chinese people. Chinese type 2 diabetic patients have an average body mass index (BMI) of about 24 kg/m², while Caucasian patients with diabetes have an average BMI of over 30 kg/m². It has been confirmed that ethnic Chinese and Japanese beta-cell function is lower than Caucasians, and newly diagnosed Chinese type 2 diabetic patients mainly exhibit postprandial hyperglycemia. These suggest that insufficient insulin secretion is a major feature in type 2 diabetic patients. Therefore, improving insulin secretion is an important way to treat type 2 diabetes, and clinical treatment should focus on improving early phase insulin secretion and controlling postprandial blood glucose.
Type 1 diabetes diagnosis and treatment problems exist where our clinicians lack understanding of the coexistence of insulin resistance in T2DM, resulting in low insulin utilization in T2DM patients with complications. Treatment still mainly focuses on oral hypoglycemic agents aimed at improving insulin secretion, leading to low application of drugs that inhibit glycosidase to improve insulin resistance. Meanwhile, clinicians' lack of knowledge regarding the hazards of hypertension and insufficient attention to antihypertensive therapy leads to less determination of blood C-peptide and insulin. Most patients are admitted to different departments due to complications, and various specialists have different focuses on recent changes in diabetes diagnosis and treatment, which is the cause of non-standard treatment of blood glucose, blood pressure, and lipids. Thus, changing and strengthening the understanding among various clinical disciplines, MD advances in diabetes treatment, and enhancing exchanges between various disciplines play a key role in enabling patients to receive early standard treatment and delaying the occurrence and development of diabetic complications.
The current situation of glycemic control is extremely unsatisfactory, so we should change traditional treatment modalities, use more aggressive treatment strategies, and strive to provide patients with better glycemic control programs to further improve the compliance rate of blood glucose control. In summary, newly diagnosed type 2 diabetes is characterized by insulin secretion insufficiency and postprandial hyperglycemia, so significantly improving early phase insulin secretion, controlling postprandial blood glucose, and medication are important parts of treatment.