Experts Recommend New Approach to Type 2 Treatment

A working group composed of researchers, clinical endocrinologists, and primary-care doctors convened by the Endocrine Society has recommended that greater emphasis be placed on regularly screening people at risk for Type 2 diabetes and promptly and aggressively treating those who have developed the condition in an attempt to preserve beta cell function. Roughly 24 million people in the United States have been diagnosed with Type 2 diabetes, and another 57 million are thought to have prediabetes.


Studies in both humans and animals have indicated that Type 2 diabetes involves dysfunctional beta cells (the insulin-producing pancreatic cells) that are not able to produce enough insulin to overcome increasing insulin resistance, another characteristic of Type 2. This failure of the beta cells appears to occur early in the progression of the disease. However, accumulating evidence indicates that the reduction in beta cell function could be slowed or potentially reversed, particularly if addressed early.

According to Jack L. Leahy, MD, one of the statement’s authors, “There is widespread evidence that the conventional approaches to the management of Type 2 diabetes have been inadequate… The increasing recognition that beta-cell failure occurs much earlier and [more] severely than commonly believed suggests that regular glycemia screening, early identification of patients at metabolic risk, and prompt and aggressive intervention deserves greater emphasis.”

The working group also recommended that researchers initiate studies to determine the usefulness of drug therapies that specifically target beta cell function.

To learn more about the recommendations, see the article “Experts Advocate Realigning Type 2 Diabetes Treatments With Disease’s Natural History” or read the consensus statement’s abstract in the Journal of Clinical Endocrinology and Metabolism. And for more information about Type 2 diabetes, click here.

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  • jim snell

    more aggresive and early treatment = you bet. also
    proper and early treatment of dawn effect and the emergency glucose add function of liver.

    failure to properly treat this is a disgrace and head up butt – you just need more exercise to burn off excess sugar – even if it takes all day.

    my type ii is now doing way better and my body response better understood with dawn effect shut down in am.

    community continues to overlook from salk institue:

    crct2 switch jammed on – on type 2 diabetecs to make sugar mode instead of fasting. good metformin pills will knock that off and shut down sugar production. 500mg up to strength in blood stream. watch out for weak sister products from Teva that do not cause switch shutdown

    when switch shutdown, sugar leakage and dawn effect shutdown drop in daily numbers.

    put me down as fed up with failure of diabetes community to properly handle

    jim snell

  • Elizabeth Bogue

    I was diagnosed 4 years ago with type 2 diabetes.
    I immediately changed my diet and began an exercise program. My A1C is very good and I feel good. The only time I have a slight rise in my blood sugar is if I am ill with a cold or if I have a high stress level for some reason. Then the diet and exercise don’t help as much. I am not on any medication. I get my eyes checked twice a year and always inspect my feet. My mother lost two toes due to diabetes and my father was on insulin twice a day. I took my diagnosis very seriously.

  • Jim Snell

    follow on comment and diet and exercise:

    Diet and exercise are now key critical to help
    better manage this monster.

    Early on, I used to wake up every day with bs glucose at 238 thru 265. After taking meds. BS would only drop to 180 no matter what. ACtos thrown at problem and that dropped it alittle more.

    I was home on disability and one thing I could do was stumble around condo park – 1/4 turn per loop.

    Finally year ago I found routinely -every day that after 8 loops – 2 miles min, I would see BS drop to 100 by 10:00am thru noon. I also noted evening BS while at 100 at early night; I would see 110 at 1:00am; 150 at 3:00am and 238-265 at 6:00 am.

    When I shared my data with other medical people about this, only real comment was your metabolism must be slow.

    Well, one day this year, I happened to take my dinner metformin late and I suddenly say my morning BS drop to 180. Checking on webb, I found meager comments about metformin and basil insulin may help.

    Well, once I had metformin 500mg schedules at 10:oopm and 12:00 am ( Based upon uptime on my body metformn uptime – 2 hours, I found dawn effect locked out from about 12:30 am thru 5:00 am and no extra glucose add from goofball liver.
    At 5:00 am I get up and take 500mg metformin plus 23 units of humolog and after 1 hour delay walk 1 to 3 times on 1/4 mile loop and liver is back in cage. It tries to make up for lost time after 5:00 am, but humolog and walk snub that out and 5:00am ingested metformin starts shutting down crct2 switch back to fasting and that merriment stops.

    So – exercise is key weapon and can help to get bs back down in sticky sitation. Diet control key and keeps one in the envelop.

    Leaky liver – when Metformin not active in blood, I have watched my liver add sugar when gut is empty. This is crct2 switch in make sugar position. I have walked and weatch BS drop after walk and as switch is in make sugar one will see liver add it back in. This is test of whether crct2 switch is on or off. When shut off, no sneaky extra sugar and one can walk down the BS with exercise and it holds for hours.

    Big dosages all at once do not work, most generic metformin works fine but Teva products don’t work.
    Spreading 500 mg doses around clock provide max crct2 switch off in fasting and reduce sugar from liver.

    now I have much more consistent numbers and no big jumps. My eyes, legs and other things have healed
    and I do not feel like marachino cherry.

  • Helen Frezieres

    Please tell me what the “dawn effect” is. I think it is connected to a hi glucose reading every morning which I have. I have type 2 Diabetes and am on Metformin 500mg 3 times a day . My readings after meals are all normal. Please explain what it is and how to obtain better fasting readings My readings are usually in the in the 120’s in the morning before food. My AIC is 6.2 so it is all happeing at night. I have tried having a snack before bed and sometimes that helps but not consistently. Thank you.

  • calgarydiabetic

    Dear Helen

    You could be deficient in your basal insulin secretion during the night. You could ask the Doctor to prescribe some lantus or levemir and try a bit at night.

  • jim snell

    re: calgary diabetic

    Interesting comments.

    1. My body real low on basil insulin secretion at night. Very low. Adding insulin-lantos at night does
    not help – tried that. In fasct regularly add at

    2, During day starlix and glyburide when used really boot up body insulin and appears to work good.

  • Bill H-D

    I agree with Jim. This is a good development, but I would really like to see the clinical community step up and recognize insulin signaling defects like the ones Jim is talking about. We need more research & more careful monitoring tools and interventions.

    Fixing the furnace when the thermostat is broken only gets you so far. ūüôā

    (me = A1C >5 after PreD diagnosis 5 years ago; my own insulin response is good now, and insulin signaling is (as far as I am able to isolate, which is not with any precision of course) relatively normal, but only at my current weight & activity level).