THERAPEUTIC APPROACHES FOR CONTROL OF TYPE 2 DIABETES: A COMPARATIVE ANALYSIS

Abstract

Type 2 diabetes mellitus (T2DM) is a prevalent chronic disease characterized by persistent hyperglycemia due to insulin resistance and/or pancreatic beta cell dysfunction. This study aims to perform a comparative analysis of current therapeutic approaches for the control of T2DM, encompassing pharmacological, non-pharmacological and emerging therapies. An integrative literature review was conducted using databases such as PubMed, Cochrane Library, Embase, CINAHL and Scopus, covering publications from the last ten years. Randomized controlled trials, observational studies, systematic reviews and meta-analyses that evaluated the efficacy and safety of various therapies for T2DM in adult patients were included. The results indicate that metformin remains the first-line treatment due to its efficacy in reducing HbA1c and favorable safety profile. Sulfonylureas, although effective, are limited by the risk of hypoglycemia and weight gain. DPP-4 inhibitors and GLP-1 receptor agonists offer additional benefits, such as weight loss and cardiovascular benefits, but may be limited by higher costs. SGLT2 inhibitors have shown dual benefits of glycemic control and reduction of cardiovascular and renal events. Insulin is essential for advanced cases, but requires close monitoring to avoid hypoglycemia. Nonpharmacological approaches, such as lifestyle modifications and bariatric surgery, have demonstrated significant efficacy in glycemic control and remission of T2DM in some cases. Emerging therapies, such as beta-cell transplantation and continuous glucose monitoring (CGM), show promise, although more research is needed. The comparative analysis highlights the need for a personalized approach, integrating pharmacological interventions, lifestyle modifications, and technological innovations. Continuous education of health professionals and patients is essential for the effective implementation of these approaches. Future studies should focus on long-term trials to evaluate clinical and economic outcomes of new therapies. It is concluded that the management of DM2 should be multifaceted and patient-centered, aiming to optimize glycemic control, reduce associated complications and improve the quality of life of patients.