Defining and characterising the progression of type 2 diabetes

Abstract

Type 2 diabetes is a progressive disease characterised by worsening of multiple abnormalities and loss of glycaemic control over time. An increasing need for glucose-lowering treatments is emphasised by the almost inevitable failure of monotherapy and occurrence of weight gain. Longer survival times and development of type 2 diabetes at a younger age also increase the risk of developing microvascular and macrovascular complications. A hallmark of type 2 diabetes mellitus is declining pancreatic β -cell function, which begins years before diagnosis and continues throughout the disease process. This deterioration continues despite initiation of numerous therapies, as these interventions lower glucose but do not directly slow β -cell decline and dysfunction. Defects in α-cell function are also important contributors to disease progression. New therapies that can counter these abnormalities without causing weight gain or hypoglycaemia continue to be assessed.Br J Diabetes Vasc Dis, 2008;8 (suppl 2): S3—S9