A Brief Discussion on Type 2 Diabetes February 22, 2001

A Brief Discussion on Type 2 Diabetes February 22, 2001

Type 2 diabetes is often a comorbidity in individuals with central obesity, accompanied by lipid abnormalities, hypertension, increased urinary microalbumin, and fibrinolytic disorders. Epidemiological studies show that about 70% of patients with type 2 diabetes die from macrovascular complications; therefore, treatment for type 2 diabetes should not merely focus on lowering blood sugar, but rather on addressing the underlying pathological changes that lead to multiple metabolic disturbances—insulin resistance. Metformin possesses these functions: it controls blood sugar while also improving macrovascular complications. Metformin reduces hepatic gluconeogenesis and inhibits muscle glycogen breakdown, thereby achieving the goal of lowering blood sugar; additionally, it can improve macrovascular complications. The reason metformin can improve macrovascular complications is mainly because it lowers triglycerides (TG), reduces LDL-C, and decreases free fatty acids (FFA); at the same time, it also helps with weight loss and raises HDL-C levels. ① The US VKPDS study shows that among a group of overweight patients with type 2 diabetes, after 10.7 years of systematic metformin treatment, the incidence of myocardial infarction decreased by 40%, and stroke also decreased by 40%; in contrast, insulin and sulfonylureas did not reduce the incidence of myocardial infarction or stroke compared to the control group. ② Metformin’s protective effect on pancreatic beta cells: it increases tissue sensitivity to insulin, thereby reducing the burden on pancreatic beta cells.