Partnering with Patients to Improve Therapeutic Outcomes: Incretin-Based Therapy for Type 2 Diabetes

Given the progressive nature of diabetes and the need for extensive patient management, it is important that physicians and patients develop a partnership to achieve therapeutic goals. At diagnosis, the diabetes care team, led by the patient, should evaluate all aspects of management, including appropriate treatment options that are suited to the patient’s quality of life, convenience, and therapeutic goals. Treatment should also consider the patient’s comorbidities, including hypertension and obesity. Management of early type 2 diabetes should include OADs and incretin-based therapies, and preference should be given to agents that do not cause either hypoglycemia or weight gain. A basal insulin should be initiated if glycemic control is not achieved with ≥ 1 agents or if presenting glucose control is poor. Irrespective of pharmacotherapy, all patients should be encouraged to maintain a healthy diet and exercise regimen. Patients also need to become active participants in disease management by monitoring blood glucose, complying with medication, adhering to lifestyle modifications, and setting weight loss goals when appropriate. This article emphasizes the need for physicians and other health care providers to partner with patients to achieve therapeutic goals and presents a novel, multifaceted approach toward improving the management of diabetes in a clinical practice setting.

Conclusion: Achieving adequate glycemic control has proved difficult for many patients with type 2 diabetes. Although effective, current therapies have significant drawbacks, including weight gain and hypoglycemia. These side effects of antidiabetes treatments often decrease adherence, resulting in poor glycemic control. With the availability of incretin-based therapies, physicians have an opportunity to provide patients with a therapy that not only addresses hyperglycemia but also the associated risk factors of type 2 diabetes, such as obesity. In addition to pharmacotherapy, physicians and other health care providers must also play a role in providing support to the patient. This can be accomplished through patient education and the development of readily available support networks. Such a partnership not only helps the patient to understand the severity of their disease, but it also promotes compliance, ultimately resulting in proper diabetes management.

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