The Cost of Managing Diabetes Mellitus: Focus on the Oral Pharmacologic Management of Type II Diabetes

OBJECTIVE: To evaluate the pharmacologic management of Type II diabetes in terms of the effect of various regimens on the metabolic abnormalities present in patients, while considering the importance of medication cost when designing a therapeutic regimen. DESIGN: Literature review. RESULTS: The primary lesion in Type II disease which causes hyperglycemia is probably insulin resistance. Hyperglycemia often is accompanied by other metabolic abnormalities, such as hyperinsulinemia, hyperlipidemia, hypertension, and weight gain. Recently, new oral medications have been introduced, including metformin and troglitazone, which address multiple metabolic abnormalities of Type II disease. Data has proven a conclusive link between poor glycemic control and the appearance and progression of complications. CONCLUSION: While cost of medication should be considered, the most effective method of cost savings in the management of Type II disease is via strict glycemic control with medications which do not adversely affe...