Vnitr Lek 2025, 71(3):144-151 | DOI: 10.36290/vnl.2025.026

Treatment of type 2 diabetes mellitus - a current view of the different drug classes and strategies for their use

Jan Brož
Interní klinika 2. LF UK a FN Motol, Praha

New drug classes targeting type 2 diabetes mellitus and their individual representatives entering clinical use in the last 10 years in particular have gradually changed the paradigm of the treatment strategy. The former central role of HbA1c with respect to combination therapy and the central role of metformin, especially in the initial treatment of a newly diagnosed patient, is modified by his cardiovascular and renal profile. The latter then, if positive or at high risk of cardiovascular disease, should be treated with SGLT2 inhibitors and/or GLP-1 receptor agonists. Initiation of treatment with these agents is not dependent on HbA1C levels or whether or not patients are taking metformin. The retreatment from oral medications with a high risk of hypoglycemia is another specific feature of the last decade, now accelerated by the expanded options to replace these medications. New therapeutic agents and the possibilities of bariatric surgery also make it possible to effectively influence the level of obesity. This article provides an up-to-date perspective on treatment strategies for this disease.

Keywords: diabetes mellitus, cardiovascular disease, hypoglycemia, obesity, HbA1c.

Accepted: April 28, 2025; Published: May 16, 2025  Show citation

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Brož J. Treatment of type 2 diabetes mellitus - a current view of the different drug classes and strategies for their use. Vnitr Lek. 2025;71(3):144-151. doi: 10.36290/vnl.2025.026.
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