Hypoglycaemia, Cardiovascular Risk, and Weight: What are the Gold Standards for Treatment of Type 2 Diabetes?

Hypoglycaemia is a side effect of diabetes treatment. It is commonly associated with symptoms that alert the individual to take corrective actions to prevent further reduction in blood glucose level. Impaired awareness of hypoglycaemia (IAH) refers to the diminished ability to pick up symptoms of hypoglycaemia. Patients with IAH may fail to take corrective actions to prevent worsening hypoglycaemia. Such individuals may potentially lose consciousness or fall into coma as blood glucose level continues to decrease. Hence, it is important to address hypoglycaemia during clinic consultations. Sodium-glucose-co-transporter 2 (SGLT2) inhibitors and Glucagon-like-peptide-1 (GLP-1) receptors agonists are two classes of diabetes treatment that target cardiovascular risk of type 2 diabetes treatments. These two agents should be used early in the course of treatment of diabetes. The gold standard for type 2 diabetes treatment should be aimed at lowering glycated haemoglobin, addressing cardiovascular risk, and minimising hypoglycaemia. Type 2 diabetes treatment should be patient-centred and individualised especially for elderly patients with significant comorbidities.