The DOI matches its Crossref record; 172 of the 172 references it cites were found in a registry or an index.
Pharmacologic Therapy for Type 2 Diabetes Mellitus
Abstract
Type 2 diabetes mellitus is a chronic metabolic disorder that results from defects in both insulin secretion and insulin action. An elevated rate of basal hepatic glucose production in the presence of hyperinsulinemia is the primary cause of fasting hyperglycemia; after a meal, impaired suppression of hepatic glucose production by insulin and decreased insulin-mediated glucose uptake by muscle contribute almost equally to postprandial hyperglycemia. In the United States, five classes of oral agents, each of which works through a different mechanism of action, are currently available to improve glycemic control in patients with type 2 diabetes. The recently completed United Kingdom Prospective Diabetes Study (UKPDS) has shown that type 2 diabetes mellitus is a progressive disorder that can be treated initially with oral agent monotherapy but will eventually require the addition of other oral agents, and that in many patients, insulin therapy will be needed to achieve targeted glycemic levels. In the UKPDS, improved glycemic control, irrespective of the agent used (sulfonylureas, metformin, or insulin), decreased the incidence of microvascular complications (retinopathy, neuropathy, and nephropathy). This review examines the goals of antihyperglycemic therapy and reviews the mechanism of action, efficacy, nonglycemic benefits, cost, and safety profile of each of the five approved classes of oral agents. A rationale for the use of these oral agents as monotherapy, in combination with each other, and in combination with insulin is provided.
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“The risk of hypoglycemia of each sulfonylurea relates to its pharmacokinetic properties (104 -108) and is highest with long-acting sulfonylureas such as chlorpropamide, glyburide (glibenclamide), and long-acting glipizide (101,109 -111).”
From Hypoglycemia in Type 2 Diabetes (2005) · cites this paper as [105]
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Cited by
Sorted by citations
Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin
(2002) · New England Journal of Medicine · doi:10.1056/nejmoa012512 · Cited by 19,011
Skeletal Muscle Insulin Resistance Is the Primary Defect in Type 2 Diabetes
DeFronzo, R. A., & Tripathy, D. (2009) · Diabetes Care · doi:10.2337/dc09-s302 · Cited by 2,102
Self-citationEffectiveness of brief alcohol interventions in primary care populations
Kaner, E. F., Beyer, F. R., Muirhead, C., Campbell, F., Pienaar, E. D., Bertholet, N., Daeppen, J. B., Saunders, J. B., & Burnand, B. (2018) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd004148.pub4 · Cited by 1,665
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Metadata
- Authors
- DeFronzo, R. A.
- Affiliations
- The University of Texas at San Antonio Health Science Center (US)
- Corresponding author
- DeFronzo, Ralph A.
- ORCID
- DeFronzo, Ralph A.
- Venue
- Annals of Internal Medicine
- Publisher
- American College of Physicians
- Published
- 1999-08-17
- Volume
- 131
- Issue
- 4
- Pages
- 281-303
- ISSN
- 0003-4819 (ISSN-L)
- 1539-3704
- OpenAlex
- W2036939737
- Cited by
- 1,173
- References
- 172
- Citations by year
- 2026: 8 · 2025: 5 · 2024: 17 · 2023: 20 · 2022: 17 · 2021: 26 · 2020: 22 · 2019: 36 · 2018: 23 · 2017: 33 · 2016: 37 · 2015: 36 · 2014: 50 · 2013: 55 · 2012: 43
- FWCI
- 10.70
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Annals of Internal Medicine (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Keywords
- type 2 diabetes, oral antidiabetic drugs, glycemic control, insulin therapy, metformin, sulfonylureas, insulin resistance, insulin secretion, hepatic glucose production, microvascular complications, UKPDS, drug safety and efficacy, combination therapy
- MeSH terms
- Troglitazone, Administration, Oral, Algorithms, Carbamates, Chromans, Diabetes Mellitus, Type 2, Humans, Hypoglycemic Agents, Insulin, Metformin, Piperidines, Sulfonylurea Compounds, Thiazoles, Trisaccharides, Evidence-Based Medicine, Acarbose, Thiazolidinediones
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