Although bariatric surgery is becoming an increasingly accepted option to reverse type 2 diabetes, lifestyle interventions, including smoking cessation, improved nutrition, and increased physical activity, coupled with appropriate pharmacotherapy, remain the mainstays for the management of type 2 diabetes.
A small clinical study shows improvements in insulin secretion and insulin sensitivity and prevention of oxidative stress with the use of alpha-lipoic acid in obese persons with impaired glucose tolerance (IGT), according to Chinese researchers.
Inhibitors of sodium glucose cotransporter (SGLT)-2 offer the promise of reducing fasting glucose and hemoglobin A1c (HbA1c) levels, independent of acting on insulin, while reducing weight, says John P. Wilding, DM. Several SGLT-2 inhibitors are in development, and one, dapagliflozin, is in phase 3 clinical studies.
Metabolic changes occur well before an actual diagnosis of type 2 diabetes, providing opportunities for screening and prevention, say British researchers. Results of the WHITEHALL II study suggest both insulin resistance and beta-cell dysfunction are likely present years before a diabetes diagnosis.
Salsalate may represent a novel treatment to lower blood glucose in patients with type 2 diabetes. Promising results from the dose-ranging first stage of the Targeting Inflammation Using Salsalate for Type 2 Diabetes (TINSAL-T2D) study support the larger stage 2 of the study to evaluate the effects of salsalate on blood glucose control over 48 weeks.