Use of sglt2 inhibitors in the treatment of type 2 diabetes. Novel agents for the treatment of type 2 2014 diabetes spectrum. Defronzo proposed the association of drugs to act in all pathophysiological defects of the disease, and not only. From the diabetes division, university of texas health science center, san antonio, texas. From the triumvirate to the ominous octet a new paradigm for the treatment of t2dm. Print diabetes ominous octet flashcards easy notecards. Bariatric surgery versus intensive medical therapy in. New paradigm for the treatment of type 2 diabetes mellitus. Bariatric surgery versus intensive medical therapy in obese patients with diabetes. The ominous octet 3 depicting the mechanism and site of action of antidiabetes.
Pathophysiologic approach to therapy in patients with newly diagnosed type 2 diabetes. The acp and its latest guidelines on type 2 diabetes mellitus. The maintenance of normal glucose homeostasis requires a complex, highly integrated interaction among the liver, muscle, adipocytes, pancreas. The good news is that learning about the octet has given us a deeper understanding of diabetes, and with it, effective ways to help you manage your care and reach your a1c goal. Glp1 ras correct six members of the ominous octet, whereas the only known action of metformin is to inhibit hepatic glucose production fig.
The word ominous suggests that something bad or unfortunate may happen in the future. Ralph defronzo describes the core defects and the natural history of type 2 dm. Print diabetes ominous octet flashcards and study them anytime, anywhere. Our model recognizes a total of 11 interlocking pathways that contribute. Pathophysiologic approach to therapy in patients with newly.
Starting noninsulin medication in the primary care. A current approach in the management of diabetes mellitus type 2. Dr ralph defronzo discusses eight core defects implicated in the pathogenesis of type 2 diabetes as described during his ominous octet banting lecture presented in 2008. This cited by count includes citations to the following articles in scholar. It now is recognized that thecell failure occurs much earlier and is more severe than previously thought. A new paradigm for the treatment of type 2 diabetes mellitus ralph a. Sep 28, 2011 the maintenance of normal glucose homeostasis requires a complex, highly integrated interaction among the liver, muscle, adipocytes, pancreas and neuroendocrine system. Dr ralph defronzo discusses 8 core defects implicated in the pathogenesis of type 2 diabetes as described during his ominous octet banting lecture. Doctors and scientists call these 8 core defects the ominous octet. Pathophysiologic approach to therapy in patients with. In people with type 2 diabetes, there are at least 8 core defects that can affect blood sugar levels.
Collectively, these 8 factors comprise the ominous octet. View ominous octet ppts online, safely and virusfree. Please keep in mind when discussing the octet that the increase in glucose reabsorption, due to. The last, and perhaps most important, player to be implicated in the pathogenesis of type 2 diabetes is the brain, which, along with his seven companions, forms the ominous octet. Defronzo i nsulin resistance in muscle and liver and cell failure represent the core pathophysiologic defects in type 2 diabetes. Muscle insulin resistance reduced glucose uptake hepatic. The ominous octet outlined in orange are the three core pathophysiologies of type 2 diabetes, known as the triumvirate.
Multiple drugs in combination may be required to improve glucose homeostasis treatment should target underlying pathophysiology poor glucose. Pathogenesis of type 2 diabetes mellitus international. Bridging the gap from phase i to proofofconcept san francisco, ca tue 8th, apr 2014. Defronzo ra diabetes 2009 follow us on social media.
Collectively, these eight players comprise the ominous octet and dictate that. Jul 17, 20 from the triumvirate to the ominous octet. Is it time to change the type 2 diabetes treatment paradigm. From 1987 to the present, our understanding of the pathophysiology of type 2 diabetes has expanded from the triumvirate of. Banting lecture from the triumvirate to the ominous octet. Resource use of twicedaily exenatide in basal insulintreated patients with type 2 diabetes. These defects, called the ominous octet, can cause diabetes to change over time and make it difficult to reach your a1c goal. Type 2 diabetes ominous octet cascade endocrinology. Successful treatment of prediabetes in clinical practice. Defronzo md professor of medicine and chief, diabetes division, the university of texas health science center at san antonio uthscsa, deputy director, texas diabetes institute, san antonio, tx, usa. Pathogenesis of type 2 diabetes mellitus springerlink.