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academies
Nov 22-23, 2018 | Paris, France
Joint Event
Nutrition and Health
16
th
International Conference on
26
th
International Conference on
Diabetes and Endocrinology
&
Journal of Insights in Nutrition and Metabolism | Volume 2
Choosing the best oral diabetic agents in T2 diabetes mellitus – Physicians challenge
Bijaya Mohanty
Tata Main Hospital, India
T
he therapeutic armamentarium of oral diabetic agents has
expanded its horizon from sulfonylureas in 1995 the only
drug available for treating type 2 diabetes mellitus at that time
to eleven classes of oral diabetes agents at present ranging
from biguanides, thiazolidinediones, dipeptidyl peptidase-4
(DPP-4) inhibitors, meglitinides, glucagon like receptor agonists,
an amylin analogue, bromocriptine, bile acid sequestrant, alpha
glucosidase inhibitors & sodium-glucose cotransporter (SGLT2)
inhibitors. Despite the availability of so many options it’s a real
challenge for the clinicians to choose the best amongst them
in treating type 2 diabetes mellitus. Before choosing the drugs,
it is important to know the recommendations of glycemic
goals in adults. A reasonable glycosylated hemoglobin (A1C)
goal in adult is <7%. However, all glycemic goals should be
individualized & customized. Setting individual glycemic goals
needs consideration of several factors like risk of hypoglycemia
& other adverse effects of drugs, disease duration, age & life
expectancy of patient’s comorbidities, vascular complications
& other individual patient considerations like patient’s attitude
resources & support system. Till today our approach towards
diabetes management is glucocentric. Lowering blood glucose
levels in patients with diabetes mellitus is a too simplistic goal.
The key component being how to achieve glycaemic control
with minimal side effects. The factors considered are efficacy
(A1C reduction), risk of hypoglycaemia, effect onweight &other
adverse effects, cost, availability, comorbidities & frequency
of administration. Patient’s preference will improve the
adherence & compliance to drugs. Therefore, a patient-centred
approach is of paramount importance while choosing the
pharmacological agents rather that establishing a universally
accepted algorithm. The advantages and disadvantages of each
class of agents help the practitioners to choose the best options.
Speaker Biography
BijayaMohantycompletedpost-graduation ingeneralmedicinefromSambalpurUniversity.
She is working as consultant &unit head in the department of medicine TataMain Hospital,
Jamshedpur, India. She had over twenty publications in various national & international
journals; hundred presentations at various forums. She is a reviewer & editorial board
member of several reputed journals.
e:
bijayamohantytmh@gmail.com