Overview and management of type 2 diabetes mellitus

Type 2 diabetes mellitus (T2DM) is a major public health concern, accounting for more than 90% of all diabetes cases. The deceptive and asymptomatic nature of the disease may result in patients not looking for early medical attention. This disease is comprised of a range of dysfunctions characterised by an increase in glucose levels in the body, and resulting from a combination of resistance to the actions of insulin, inadequate insulin secretion and excessive or inappropriate glucagon secretion. Genetic factors related to impaired insulin secretion, insulin resistance, social influences (e.g. obesity, overeating and aging), and environmental factors form part of the pathophysiology. Classic symptoms of T2DM include polydipsia, polyuria, polyphagia, and weight loss. The treatment approach is a combination of non-pharmacological measures, such as diet and exercise, and using pharmacological measures in the form of different medicines, including the biguanides, sulphonylureas, thiazolidinediones, alpha-glucosidase inhibitors, insulin, DPP4-inhibitors, GLP-1 agonists and SGLT2-inhibitors. Good control of glycaemia, blood pressure and dyslipidaemia, combined with frequent examinations for microvascular and macrovascular complications, with appropriate and timely interventions, is the only way to reduce morbidity and mortality associated with this disease. This article provides an overview of diabetes mellitus type 2 and the management thereof.