Insulin Resistance, Type 1 And Type 2 Diabetes, And Related Complications 2017
Copyright © 2017 Joseph Fomusi Ndisang et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The global escalation of obesity and diabetes in developed and developing nations poses a great health challenge. Obesity is one of the major causes of type 2 diabetes. Type 1 diabetes is primarily due to the autoimmune-mediated destruction of pancreatic beta cell leading to insulin deficiency [1–3]. This is usually accompanied by alterations in lipid metabolism, enhanced hyperglycemia-mediated oxidative stress, endothelial cell dysfunction, and apoptosis [1–3]. Similarly, in type 2 diabetes, increased glucotoxicity, lipotoxicity, endoplasmic reticulum-induced stress, and apoptosis lead to the progressive loss of beta cells [1–5]. While type 1 diabetes is characterized by the presence of beta cell autoantibodies, a combination of peripheral insulin resistance and dysfunctional insulin secretion by pancreatic beta cells is implicated in the pathogenesis of type 2 diabetes [1–3]. However, both forms of diabetes are associated by a wide variety of complications such as cardiomyopathy, nephropathy, and neuropathy. Although insulin resistance has traditionally been associated with type 2 diabetes, mounting evidence indicates that the incidence of insulin resistance in type 1 diabetes is increasing [6]; therefore, novel mechanistic approaches deciphering insulin resistance are needed. Many pathophysiological factors are implicated in insulin resistance [5, 7]. Although the exact natures of these factors are not completely understood, it is widely accepted that oxidative stress, inflammation, and genetic, habitu Continue reading >>
All Type 2 Diabetes Articles
Diabetes medical groups consider the impact of less intense A1C target goals recently suggested by the American College of Physicians. Will this debate influence the way you manage your diabetes? Diabetes organizations consider the impact of less intense A1C target goals recently suggested by the American College of Physicians. Will this debate influence the way you manage your diabetes? In a new study, researchers found short, intense workouts can improve memory quickly. Might this finding be a better motivator than weight loss? Canadian researchers found that short, intense workouts can improve memory quickly. Could more brain power be a better motivator than weight loss? FDA approves semaglutide (Ozempic), which improved A1C and weight loss in clinical trials. Swedish study finds that cancers identified within two years of a normal mammogram were larger in overweight, obese women. Swedish study finds that cancers identified within two years of a normal mammogram were larger in overweight, obese women. Lifestyle changes and in some cases, surgery, can be effective ways to put type 2 diabetes into remission. Learn more about what you can do to get off medication and get in control. Experts say it's possible to put type 2 diabetes into remission. Lifestyle changes and, in some cases, bariatric surgery can help get you off medication. The scientifically-proven 7-minute workout has been shown to have impressive benefits but can it be helpful for people with type 2 diabetes? Incorporate exercise into your treatment plan for reduced body mass index, smaller hip and waist circumference and improved sensitivity to insulin. Researchers from Taiwan found that chronic insomnia raises the risk of type 2 diabetes. What does lack of sleep have to do with diabetes? New research rev Continue reading >>
Journal Of Diabetes Research
Timing of Exercise Affects Glycemic Control in Type 2 Diabetes Patients Treated with Metformin , Tao Huang, Chunyan Lu, Moritz Schumann, Shenglong Le, Yifan Yang, Haihui Zhuang, Qingwei Lu, Jinsheng Liu, Petri Wiklund, and Sulin Cheng Volume 2018 (2018),Article ID 2483273, 9 pages Previous Exercise Training Reduces Markers of Renal Oxidative Stress and Inflammation in Streptozotocin-Induced Diabetic Female Rats , Liliany Souza de Brito Amaral, Cludia Silva Souza, Rildo Aparecido Volpini, Maria Heloisa Massola Shimizu, Ana Carolina de Bragana, Daniele Canale, Antonio Carlos Seguro, Terezila Machado Coimbra, Amlia Cristina Mendes de Magalhes, and Telma de Jesus Soares Volume 2018 (2018),Article ID 6170352, 9 pages Diabetes-Related Distress Assessment among Type 2 Diabetes Patients , Majed O. Aljuaid, Abdulmajeed M. Almutairi, Mohammed A. Assiri, Dhifallah M. Almalki, and Khaled Alswat Volume 2018 (2018),Article ID 7328128, 10 pages Red Blood Cell Distribution Width Is Associated with Carotid Atherosclerosis in People with Type 2 Diabetes , J. S. Nam, C. W. Ahn, S. Kang, K. R. Kim, and J. S. Park Volume 2018 (2018),Article ID 1792760, 6 pages Genetic Variability of the Glucose-Dependent Insulinotropic Peptide Gene Is Involved in the Premature Coronary Artery Disease in a Chinese Population with Type 2 Diabetes , Xiaowei Ma, Jia Huang, Difei Lu, Nan Gu, Ran Lu, Jianwei Zhang, Hong Zhang, Jianping Li, Junqing Zhang, and Xiaohui Guo Volume 2018 (2018),Article ID 6820294, 7 pages Insulin Secretion and Risk for Future Diabetes in Subjects with a Nonpositive Insulinogenic Index , Daisuke Aono, Rie Oka, Mitsuhiro Kometani, Yoshimichi Takeda, Shigehiro Karashima, Kenichi Yoshimura, Yoshiyu Takeda, and Takashi Yoneda Volume 2018 (2018),Article ID 5107589, 9 pages Advanced Glycatio Continue reading >>
- Turmeric Extract 100% Effective At Preventing Type 2 Diabetes, ADA Journal Study Finds
- EnteroMedics Announces Publication of Three-Year Data from vBloc Diabetic Patient Study in Journal of Diabetes and Obesity
- Practical Approach to Using Trend Arrows on the Dexcom G5 CGM System for the Management of Adults With Diabetes | Journal of the Endocrine Society | Oxford Academic
Insulin Resistance, Type 1 And Type 2 Diabetes, And Related Complications 2015
Copyright © 2015 Joseph Fomusi Ndisang et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The dramatic increase in obesity and diabetes worldwide poses a huge socioeconomic burden to healthcare systems. In type 1 diabetes, autoimmune-mediated destruction of pancreatic beta-cell results in insulin deficiency [1]. Obesity is one of the major causes of type 2 diabetes [1–3]. In type 2 diabetes, a combination of peripheral insulin resistance and aberrant production of insulin are amongst the paradox commonly encountered in the pathogenesis of the disease [1–3]. However, both forms of diabetes are characterized by elevated inflammation/oxidative stress, glucotoxicity, lipotoxicity, endoplasmic reticulum-induced stress with increased apoptosis and necrosis that ultimately leads to destruction loss of beta cells, and related complications including cardiomyopathy, nephropathy, neuropathy, and hepatopathy [1, 4–7]. Although insulin resistance has traditionally been associated with type 2 diabetes, recent evidence suggests that insulin resistance in type 1 diabetes is increasing [8–10]; therefore, novel mechanistic approaches deciphering insulin resistance are needed. The etiology of insulin resistance is complicated and several factors are implicated, so deciphering this multifaceted disease remains challenging, although a wide body of evidence suggests that oxidative stress, inflammation, genetic, habitual, environmental, and epigenetic factors may be involved [1, 11]. Thus, further research is needed for more in-depth and comprehensive understanding of the pathophysiology of insulin resistance in bo Continue reading >>
Type 2 Diabetes Mellitus: A Review Of Current Trends
Go to: Introduction Diabetes mellitus (DM) is probably one of the oldest diseases known to man. It was first reported in Egyptian manuscript about 3000 years ago.1 In 1936, the distinction between type 1 and type 2 DM was clearly made.2 Type 2 DM was first described as a component of metabolic syndrome in 1988.3 Type 2 DM (formerly known as non-insulin dependent DM) is the most common form of DM characterized by hyperglycemia, insulin resistance, and relative insulin deficiency.4 Type 2 DM results from interaction between genetic, environmental and behavioral risk factors.5,6 People living with type 2 DM are more vulnerable to various forms of both short- and long-term complications, which often lead to their premature death. This tendency of increased morbidity and mortality is seen in patients with type 2 DM because of the commonness of this type of DM, its insidious onset and late recognition, especially in resource-poor developing countries like Africa.7 Epidemiology It is estimated that 366 million people had DM in 2011; by 2030 this would have risen to 552 million.8 The number of people with type 2 DM is increasing in every country with 80% of people with DM living in low- and middle-income countries. DM caused 4.6 million deaths in 2011.8 It is estimated that 439 million people would have type 2 DM by the year 2030.9 The incidence of type 2 DM varies substantially from one geographical region to the other as a result of environmental and lifestyle risk factors.10 Literature search has shown that there are few data available on the prevalence of type 2 DM in Africa as a whole. Studies examining data trends within Africa point to evidence of a dramatic increase in prevalence in both rural and urban setting, and affecting both gender equally.11 The majority of the D Continue reading >>
Obesity And Type 2 Diabetes Mellitus
It is now widely accepted that the obesity epidemic continues to be the principal driver for the rising global prevalence of type 2 diabetes mellitus (1). With the unabated increase in the prevalence of obesity, every year the World Health Organization (WHO) has to increase the projected global figures of the number of people with diabetes for 2030. The latest figure of 532 million people who will develop diabetes by 2030 will likely be revised (2). Canada's obesity prevalence rate of 25.5% ranks fourth among the OECD countries, behind the United States (34.3%), Mexico (30%) and New Zealand (26.5%), and ahead of the United Kingdom (24%) (1). Sadly, the latest figures on adult Canadians who are overweight and obese based on self-reported body mass indices show no reversal in its prevalence and trends. According to data released by Statistics Canada earlier this year (based on self-reported body mass indices), 52% of Canadians age 18 years and over are overweight or obese (3). The number of overweight/obese Canadians continue to rise over the past 5 years, from 12.1 million in 2007 to 13.2 million in 2011 (8.8% increase) (3). More than 60% of men age 35 years and older are overweight or obese and there has been a 20% increase since 2007 (3). Over the last 2 decades, the average self-reported body mass index (BMI) of adult Canadians has increased by approximately 3 kg/m2, from 22.3 to 25.3 kg/m2, which is in the overweight range (4). Obesity rates have roughly doubled across all age groups over the past 3 decades, and we are less physically fit (5)! Importantly, 20% of Canadian youths are overweight or obese, and the number continues to rise, notably in the Maritime provinces (3). This issue of the Canadian Journal of Diabetes, published on the occasion of the 3rd Canadian Continue reading >>
Type 2 Diabetes: Pharmacological Management Strategies
Currently, there are over 2.8 million people in the UK with type 2 diabetes, a number expected to rise by over 50% by 2030. In the image, polarised light micrograph of glynase, used to treat type 2 diabetes In this article you will learn: The current pharmacological strategies for management of patients with type 2 diabetes The status of newer therapies targeting the incretin axis and renal glucose handling The status of newer, longer-acting insulins Diabetes affects around 382 million people worldwide[1] and the numbers are increasing. In the UK, more than 2.8 million people have type 2 diabetes with an estimated cost to the NHS of £12bn a year[2]. On account of rising obesity and changes in the ethnic make up of the UK population, the number of people in the UK with diabetes is expected to rise by over 50% by 2030[3]. This represents a huge societal and financial burden on healthcare systems. Type 2 diabetes is a metabolic disorder characterised by persistent hyperglycaemia caused by the body’s own resistance to endogenous insulin and an inevitable gradual failure of pancreatic beta cells to respond and produce sufficient insulin to meet demand. Genetic factors predispose people to developing type 2 diabetes, but it is strongly linked with obesity and modern inactive and unhealthy lifestyles. People from ethnic minorities in the UK are more likely to have type 2 diabetes than the general population[3]. Family history is an important risk factor and twin studies have shown higher concordance for diabetes in monozygotic compared with dizygotic twins[4]. More than 65 genetic variants have been identified that increase the risk of a person developing diabetes[5], but it is not currently possible to use this information clinically to ascertain an individual’s risk. In Continue reading >>
Risk Factors Contributing To Type 2 Diabetes And Recent Advances In The Treatment And Prevention
Top Introduction Epidemiology Correlations with and... Complications Treatment of T2DM Risk assessment Lifestyle intervention for... Conclusions Acknowledgements References Author biography PDF 1. Lab of Molecular Immunology, Zhejiang Provincial Center for Disease Control and Prevention, 3399 Binsheng Road, Hangzhou, 310051, China; 2. Lab of Chemical Biology and Molecular Drug Design, College of Pharmaceutical Science, Zhejiang University of Technology, 18 Chaowang Road, Hangzhou, 310014, China; 3. Center for Innovation in Immunoregulative Technology and Therapeutics, Graduate School of Medicine, Kyoto University, Kyoto, 606-8501, Japan. How to cite this article: Wu Y, Ding Y, Tanaka Y, Zhang W. Risk Factors Contributing to Type 2 Diabetes and Recent Advances in the Treatment and Prevention. Int J Med Sci 2014; 11(11):1185-1200. doi:10.7150/ijms.10001. Available from Abstract Type 2 diabetes is a serious and common chronic disease resulting from a complex inheritance-environment interaction along with other risk factors such as obesity and sedentary lifestyle. Type 2 diabetes and its complications constitute a major worldwide public health problem, affecting almost all populations in both developed and developing countries with high rates of diabetes-related morbidity and mortality. The prevalence of type 2 diabetes has been increasing exponentially, and a high prevalence rate has been observed in developing countries and in populations undergoing “westernization” or modernization. Multiple risk factors of diabetes, delayed diagnosis until micro- and macro-vascular complications arise, life-threatening complications, failure of the current therapies, and financial costs for the treatment of this disease, make it necessary to develop new efficient therapy strategies Continue reading >>
Prevalence, Awareness, Treatment, Control Of Type 2 Diabetes Mellitus And Risk Factors In Chinese Rural Population: The Ruraldiab Study
The study aimed to investigate prevalence, awareness, treatment and control of type 2 diabetes mellitus (T2DM), and to explore potential risk factors in rural areas of China. A total of 16413 individuals aged 18–74 years in rural districts were recruited from the Rural Diabetes, Obesity and Lifestyle (RuralDiab) study for the epidemiological research. Meanwhile, a meta-analysis including 7 published studies was conducted to validate the result of the cross-sectional study. The rates of crude and age-standardized prevalence, awareness, treatment and control of T2DM were 12.19%, 67.00%, 62.35%, 22.20% and 6.98%, 60.11%, 54.85%, 18.77%, respectively. The prevalence, awareness, treatment and control of T2DM displayed increased trends with age (Ptrend < 0.01) and were strongly associated with education, drinking, more vegetable and fruit intake, physical activity, family history of diabetes, body mass index (BMI). The results of this meta-analysis showed that the pooled prevalence, awareness, treatment and control of T2DM in China countryside were 7.3% (5.3–9.4%), 57.3% (36.9–77.6%), 48.4% (32.4–64.5%) and 21.0% (9.9–32.1%), respectively. The prevalence of T2DM was high with inadequate awareness, treatment and control of T2DM in China rural areas. Healthy lifestyles should be advocated to reduce prevalence and improve awareness, treatment, and control of T2DM in Chinese rural residents. As the third leading cause of mortality, diabetes seriously threatens to human health worldwide1,2, and it has caused large disease burden to the patients, their families and the society, especially in developing countries3,4,5. There are many complications of diabetes such as diabetic eye disease and diabetic nephropathy, which could lead to blindness and kidney failure5,6,7. In ad Continue reading >>
- Prevalence of and Risk Factors for Diabetic Peripheral Neuropathy in Youth With Type 1 and Type 2 Diabetes: SEARCH for Diabetes in Youth Study
- Maternal obesity as a risk factor for early childhood type 1 diabetes: a nationwide, prospective, population-based case–control study
- Prevalence of diabetes and prediabetes in 15 states of India: results from the ICMR–INDIAB population-based cross-sectional study
Type 2 Diabetes Mellitus: Update On Diagnosis, Pathophysiology, And Treatment
Type 2 Diabetes Mellitus: Update on Diagnosis, Pathophysiology, and Treatment Division of Diabetes, Endocrinology, and Metabolism, Cornell University Medical College, New York, New York 10021 Search for other works by this author on: Division of Diabetes, Endocrinology, and Metabolism, Cornell University Medical College, New York, New York 10021 Search for other works by this author on: The Journal of Clinical Endocrinology & Metabolism, Volume 84, Issue 4, 1 April 1999, Pages 11651171, Richard J. Mahler, Michael L. Adler; Type 2 Diabetes Mellitus: Update on Diagnosis, Pathophysiology, and Treatment, The Journal of Clinical Endocrinology & Metabolism, Volume 84, Issue 4, 1 April 1999, Pages 11651171, SIXTEEN million individuals in the United States with type 2 diabetes mellitus and an additional 3040 million with impaired glucose tolerance result in health care costs exceeding 100 billion dollars annually ( 1 ). Treatment is predominantly directed at microvascular and macrovascular complications ( 2 ). In type 1 diabetes mellitus the relationship between glycemic control and microvascular complications has been well established ( 3 ). The relationship between tight glycemic control and microvascular disease in type 2 diabetes mellitus appears to be established in the recently completed United Kingdom prospective diabetes study ( 4 , 5 ). Despite the morbidity and mortality associated with retinopathy, nephropathy, and neuropathy, cardiovascular disease remains the leading cause of death in type 2 diabetes mellitus ( 6 , 7 ). Consequently, the treatment of confounding risk factors of obesity, hypertension, and hyperlipidemia assumes major importance and must be coordinated with good glycemic control for reduction in total mortality in type 2 diabetes mellitus ( 6 11 ). Continue reading >>
Diabetes Type 2
Diabetes means your blood glucose, or blood sugar, levels are too high. With type 2 diabetes, the more common type, your body does not make or use insulin well. Insulin is a hormone that helps glucose get into your cells to give them energy. Without insulin, too much glucose stays in your blood. Over time, high blood glucose can lead to serious problems with your heart, eyes, kidneys, nerves, and gums and teeth. You have a higher risk of type 2 diabetes if you are older, have obesity, have a family history of diabetes, or do not exercise. Having prediabetes also increases your risk. Prediabetes means that your blood sugar is higher than normal but not high enough to be called diabetes. If you are at risk for type 2 diabetes, you may be able to delay or prevent developing it by making some lifestyle changes. The symptoms of type 2 diabetes appear slowly. Some people do not notice symptoms at all. The symptoms can include Being very thirsty Urinating often Feeling very hungry or tired Losing weight without trying Having sores that heal slowly Having blurry eyesight Blood tests can show if you have diabetes. One type of test, the A1C, can also check on how you are managing your diabetes. Many people can manage their diabetes through healthy eating, physical activity, and blood glucose testing. Some people also need to take diabetes medicines. NIH: National Institute of Diabetes and Digestive and Kidney Diseases Continue reading >>
The Early Treatment Of Type 2 Diabetes
Abstract The growing epidemic of type 2 diabetes is one of the leading causes of premature morbidity and mortality worldwide, mainly due to the micro- and macrovascular complications associated with the disease. A growing body of evidence suggests that although the risk of developing complications is greater with glucose levels beyond the established threshold for diagnosis – increasing in parallel with rising hyperglycemia—individuals with glucose levels in the prediabetic range are already at increased risk. Early intervention, ideally as soon as abnormalities in glucose homeostasis are detected, is of great importance to minimize the burden of the disease. However, as the early stages of the disease are asymptomatic, diagnosing prediabetes and early overt type 2 diabetes is challenging. The aim of this article is to discuss these challenges, the benefits of early intervention—with emphasis on the prevention trials showing that progression to type 2 diabetes can be delayed by addressing prediabetes—and the existing evidence-based guidelines that have been drawn to optimize the standards of care at the prediabetes and overt type 2 diabetes stages. Continue reading >>
- Symptoms of EARLY diabetes: Five risk factors putting YOU on course for type 2 diabetes
- Relative effectiveness of insulin pump treatment over multiple daily injections and structured education during flexible intensive insulin treatment for type 1 diabetes: cluster randomised trial (REPOSE)
- Type 2 diabetes: Symptoms, early signs, and complications
Patient Access To Research
This research confirms that the presence of elevated FABP4 during pregnancy can predict pre-eclampsia in women with type 1 diabetes and suggests it may be an important biomarker for use in screening. Be Nicer to Yourself, and Your A1C Will Thank You: Self-Compassion, Depression, and Diabetes This study suggests that learning to be kinder to oneself (rather than being harshly self-critical) may have both emotional and metabolic benefits among patients with diabetes. The ability to be kind and to understand oneself in the face of difficult feelings may be important for reducing the suffering linked to depression and distress and for improving A1Cthe key clinical marker of effective diabetes management. The benefits of developing self-compassion might also extend to other chronically ill populations. Sniffing Out Hypoglycemia: How Dogs Can Detect Low Blood Glucose Levels These findings suggest that detection of a chemical in the breath called isoprene may offer an easy alternative to monitoring changes in blood glucose levels for people with diabetes. This also likely explains how dogs can detect (and can be trained to detect) low blood glucose levels in their owners. Bariatric Surgery Beats Diet and Exercise in a Head-to-Head Comparison According to the findings of this study, compared with aggressive diet and exercise, RYGB surgery results in greater weight loss, leads to type 2 diabetes remission more often, and offers tighter blood glucose control, in addition to improvements in other risk factors for heart disease, in patients who are mild-to-moderately obese. According to these findings, type 2 diabetes is a potentially reversible condition. An intense weight loss program was able to eliminate diabetes in participants for at least 6 months. This study suggests that Continue reading >>
Targeting Vitamin D Receptors Could Prevent Type 2 Diabetes
Targeting vitamin D receptors could prevent type 2 diabetes Research suggests that targeting vitamin D receptors could protect the insulin-producing function of beta cells. Targeting vitamin D receptors in insulin-producing cells could be an effective way to prevent type 2 diabetes, suggests a new study. Researchers found that treating mice with vitamin D , lithocholic acid (LCA) propionate, and other vitamin D receptor agonists stopped dedifferentiation in mouse-derived beta cells, which is a process that has been linked to the development of type 2 diabetes . Study co-author Fang-Xu Jiang, of the Harry Perkins Institute of Medical Research in Western Australia, and colleagues recently reported their findings in the journal Diabetes & Metabolism. It is estimated that around 30.3 million people in the United States have diabetes , and around 1.5 million new cases are diagnosed every year. Type 2 diabetes is the most common form of diabetes,arising when the beta cells of the pancreas are unable to produce sufficient amounts of insulin - the hormone that regulates blood glucose levels - or when the body is unable to use insulin effectively. Overweight, obesity , hypertension , and high cholesterol are some more well-known risk factors for type 2 diabetes, but previous research has suggested that low levels of vitamin D may also play a role. According to Jiang, precisely how low vitamin D might fuel the development of type 2 diabetes has been unclear. Their new study sheds light on the process, and it may have identified a way to prevent and treat one ofthe biggest health burdens in the U.S. Jiang and colleagues came to their findings by studying the insulin-producing beta cells of mice. In a high-glucose environment, the expression of vitamin D receptors in the beta cell Continue reading >>
Self-monitoring Of Blood Glucose In Treatment Of Type 2 Diabetes
Volume 86, Supplement 1 , December 2009, Pages S49-S52 Self-monitoring of blood glucose in treatment of type 2 diabetes Author links open overlay panel AleksandraSzymborska-Kajaneka AnnaPsureka RobertHeseb KrzysztofStrojeka Get rights and content Blood glucose measurements are important components of a effective diabetes management. Self-monitoring of blood glucose (SMBG) provides the possibility for collecting information on glucose levels at different timepoints and facilitates patient empowerment. However, the efficacy of SMBG in particular groups of patients is controversial. Self-monitoring is postulated to have a beneficial effect on metabolic control in type 1 diabetes as it is essential to adjust insulin doses. In type 2 diabetes the efficacy of frequent glucose measurements remains uncertain. The purpose of this paper is to overview recent data in the field of self-control to evaluate the influence of SMBG on glycaemic control in type 2 diabetes. The results of studies suggest that SMBG can have an important role in improving metabolic control if it is an integral part of a wider educational strategy. SMBG can be especially recommended for type 2 diabetic patients with suboptimal metabolic control in order to promote dietary and lifestyle changes as well as treatment correction as a response to feedback provided by blood glucose results. Continue reading >>
- Postprandial Blood Glucose Is a Stronger Predictor of Cardiovascular Events Than Fasting Blood Glucose in Type 2 Diabetes Mellitus, Particularly in Women: Lessons from the San Luigi Gonzaga Diabetes Study
- Relative effectiveness of insulin pump treatment over multiple daily injections and structured education during flexible intensive insulin treatment for type 1 diabetes: cluster randomised trial (REPOSE)
- Is It Time to Change the Type 2 Diabetes Treatment Paradigm? No! Metformin Should Remain the Foundation Therapy for Type 2 Diabetes
