Dealing with complexity in type 2 diabetes

The management of people with type 2 diabetes (or type 2 diabetes mellitus) can be complex and sits largely within the portfolio of primary care. Unfortunately, despite an ever-increasing therapeutic armoury, many people with type 2 diabetes fail to achieve optimal control of their blood glucose and other metabolic indices, putting them at higher risk of diabetes-related complications. The situation has sadly changed little over recent years. People with type 2 diabetes often have other long-term health concerns that need to be recognised and addressed alongside more traditional parameters such as blood glucose and blood pressure. In this article, we will consider the recognition and management of two of the more common conditions that co-exist in people with type 2 diabetes: Diabetes distress and renal disease. Although there is undoubtedly some overlap with type 1 diabetes, the discussion in this article solely relates to the management of type 2 diabetes.