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Pathophysiological Rationale for Combination Therapy vs. Conventional Stepwise Treatment Approach

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Dr Ambrish Mithal, Gurugram    23 November 2018

  1.  The ominous octet”: Decreased incretin effect, increased lipolysis, increased glucose reabsorption, decreased glucose uptake, increased hepatic glucose production, neurotransmitter dysfunction, increased glucagon secretion, decreased insulin secretion.
  2. Lifestyle intervention and metformin are still the gold standard.
  3. Pharmacotherapy should be tailored according to the phenotype.
  4. Management of comorbidities is as equally important as glycemic control.
  5. Drugs that target the pathophysiologic defects should be given rather than conventional step-up strategy.

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