Comparative Effectiveness and Safety of Oral Diabetes Medications for Adults With Type 2 Diabetes. Executive Summary. Effective Health Care Number 8

摘要

Type 2 diabetes is characterized by insulin resistance accompanied by progressive deficiency in insulin secretion. Type 2 diabetes is an increasingly common disease that is closely associated with obesity. In 2005, the prevalence of Americans with diagnosed type 2 diabetes was 2.4 percent for adults aged 20-39 years, 10 percent for adults aged 40-59 years, and 21 percent for adults aged 60 years or over. From 1980 through 2004, the number of Americans diagnosed with diabetes more than doubled, from 5.8 million to 14.7 million. Observational studies and clinical trials show that improved glycemic control reduces microvascular complications (e.g., complications involving the eyes, kidneys, or nerves) and may reduce macrovascular complications (e.g., heart attack); however, the effects of specific oral diabetes medications on these outcomes are less certain. As new classes of medications have become available for the treatment of diabetes, clinicians and patients have faced a bewildering array of oral medications with different mechanisms of action.