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PHiE 2019, 100(2)

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Probl Hig Epidemiol 2019, 100(2): 75-81pl

Type 2 diabetes - epidemiology and pharmacotherapy

Sławomir Grycel 1/, Agnieszka Błachnio-Zabielska 2/

1/ Somed Specjalistyczny Ośrodek Medyczny w Łomży
2/ Zakład Higieny, Epidemiologii i Zaburzeń Metabolicznych, Uniwersytet Medyczny w Białymstoku

Diabetes is a chronic metabolic disorder manifested by hyperglycaemia. which is the result of impaired insulin secretion or its improper action. The most common form of this disease is type 2 diabetes (T2D), which is based on insulin resistance. Type 2 diabetes accounts for approx. 90% of all cases of diabetes, and the incidence of T2D is constantly increasing. In contrast to type 1 diabetes, where insulin is needed, there are other therapeutic options for T2D treatment. The first choice in T2D treatment is Metformin, which mainly inhibits hepatic gluconeogenesis, and sulfonylurea, which enhances insulin secretion. Other drugs are glinides, whose action is similar to sulfonylurea derivatives. The next group of medications are glitazones, which are agonists of the PPAR receptors. Another group of drugs are inhibitors of the intestinal brush-edge enzyme - α-glucosidase which is responsible for the hydrolysis of complex carbohydrates, hence the action of this group of drugs is based on reducing the absorption of carbohydrates from the gastrointestinal tract. The next group of drugs used in the treatment of T2D are incretin drugs, which are analogues of the GLP-1 peptide and act via the GLP-1 receptor. Their action is based on increasing insulin secretion and inhibiting the secretion of glucagon. Flosins are a relatively new group of drugs which are inhibitors of sodium-glucose glucose transporter 2, leading to a reduction in the resorption of glucose in the kidneys, and hence decreases its concentration in the blood. In the treatment of T2D, insulin is also used when there are contraindications for the use of the above-mentioned drugs, or their effect is insufficient to regulate glycemia.

Key words:  type 2 diabetes, Metformin, sulfonylureas, insulin, insulin resistance