Summary
This narrative review synthesises current understanding of type 2 diabetes mellitus pathogenesis, emphasising the roles of insulin resistance, β-cell dedifferentiation, mitochondrial dysfunction, and oxidative stress. The authors argue for a treatment hierarchy prioritising non-pharmacological interventions—including dietary modification, physical activity, and cognitive-behavioural therapy—with advanced pharmacotherapies such as SGLT2 inhibitors and GLP-1 receptor agonists as complementary options. The review underscores the importance of early diagnosis and comprehensive management to prevent or delay complications including diabetic kidney disease, retinopathy, and neuropathy.
Regional applicability
This is a clinical review without specified study geography; its epidemiological scope (over 400 million people globally) and treatment recommendations are broadly applicable to United Kingdom healthcare practice, though specific drug availability and National Health Service formulary status would require UK-specific policy assessment.
Key measures
Glycaemic control, weight control, cardiovascular risk, kidney function, retinal outcomes, neuropathic complications
Outcomes reported
The paper reviews pathogenic mechanisms underlying type 2 diabetes mellitus, including insulin resistance and β-cell dysfunction, and evaluates both non-pharmacological interventions (physical activity, dietary modification, cognitive-behavioural therapy) and advanced pharmacological therapies (SGLT2 inhibitors, GLP-1 receptor agonists). It also addresses major complications including diabetic kidney disease, retinopathy, and neuropathy.
Topic tags
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