Abstract

Treatment of Type 2 diabetes is  not limited to just glycaemic control. Rather, the proper management of hyperglycaemia, weight, blood pressure, and lipids can have benefits in terms of slowing the progression of Type 2 diabetes, decreasing the risk of CV disease, and improving overall health. Current antihyperglycaemic treatments are predominantly insulin-dependent. These treatments can effectively manage HbA1c, and treatment may be influenced by the patient’s comorbidities and any potential treatment-related adverse events. However, as Type 2 diabetes progresses, regimens need to be modified to compensate for declining beta-cell function and decreasing insulin sensitivity. On this basis, the EASD/ADA guidelines suggest following a treatment pathway that has well validated therapies at its core. Of the many comorbid conditions described, excess weight is especially important, not only because of the increased disease risk, but also for the management of blood pressure and lipids. Consequently, AACE/ACE algorithms give priority to those regimens that have the added benefit of minimising hypoglycaemic events and weight gain. In addition, while antidiabetic treatments tend to focus on insulin-dependent mechanisms in organs such as the liver and pancreas, it should not be forgotten that the kidneys also have a role in maintaining