20/08/2026
Management of Type 2 Diabetes β A Practical Clinical Approach
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Type 2 Diabetes Mellitus (T2DM) is no longer just a disease of sugar , it is a disease of the heart, kidneys, brain, and blood vessels. Early, structured, and individualized management is the key to preventing lifelong complications.
πΉ 1. Lifestyle Modification β The Foundation
No medicine can replace:
β’ Balanced, low-glycemic diet
β’ Regular physical activity (150 minutes/week)
β’ Weight control and sleep hygiene
πΉ 2. First-line Therapy β Metformin
Metformin remains the backbone of treatment due to its:
β’ Proven glucose control
β’ Weight neutrality
β’ Cardiovascular safety
β’ Low cost
πΉ 3. Add-on Therapy Should Be Patient-Centered
Treatment should be chosen based on comorbidities:
β’ Obesity β GLP-1 receptor agonists
β’ Heart failure / CKD β SGLT2 inhibitors
β’ Elderly β DPP-4 inhibitors
β’ Cost concern β Sulfonylureas
πΉ 4. When to Start Insulin
Insulin is not a failure β it is a life-saving tool when:
β’ HbA1c >10%
β’ Random glucose >300 mg/dL
β’ Weight loss, ketosis, infection, surgery
πΉ 5. Monitoring Is As Important As Treatment
β’ HbA1c every 3 months
β’ Kidney, eye, foot screening yearly
β’ Blood pressure and lipid control
