Abstract
Evidence suggests that intensive treatment might lead to improved long-term compensation of patients with type 2 diabetes. However, extensive therapy with anti-diabetic agents is required due to disease progression.
Treatment must be based on gradual titration, according to glycaemia, to individually determined target values (according to age, disease duration, micro a macrovascular complications, risk of hypoglycaemia and presence of risk factors). Normalization of glycaemia in younger individuals with shorter duration of diabetes (up to 10- 15 years) also decreases cardiovascular risk.
In contrast, the increased risk of hypoglycaemia associated with intensive therapy in patients with advanced changes in coronary arteries, with long-term diabetes, might lead to increased risk of morbidity. Consequently, it is imperative to individualise treatment targets and select therapy that minimizes the risk of hypoglycaemia.
Appropriateness of the selected treatment is determined by treatment outcome - achievement of tight diabetes compensation without adverse effects and with negligible risk of hypoglycaemia.