Review of current guidelines for the treatment of type 2 diabetes

According to the WHO, diabetes is one of the five most dangerous chronic non-communicable diseases in the world. The annual increase in the number of patients with diabetes in Ukraine is about 5-10%. In 2020, the WHO published new guidelines for the diagnosis and treatment of diabetes and updated its classification. Along with the already familiar type 1 and 2 diabetes and gestational diabetes, a new category of disease has emerged – hybrid forms of diabetes. In the section «Pharmacological management of diabetes» the WHO gives priority to the level of glycemia, the control of which avoids the development of microvascular complications of type 2 diabetes. Initial treatment, according to the WHO 2020, should begin with the appointment of metformin - a drug of the first line of treatment of patients with this disease. It is important that metformin does not cause weight gain, does not provoke hypoglycemia and is recommended for the treatment of people who do not reach the desired level of glycemia through diet and physical activity. Secondgeneration sulfonylureas can be used as an initial first-line treatment when metformin is contraindicated or intolerant. However, this is quite rare: in most cases, metformin is well tolerated by patients if administered gradually. That is, metformin, and, if necessary, sulfonylureas - is an effective, safe and affordable choice compared to expensive novelties, the effectiveness and safety of which have not been proven in long-term studies. In addition, in type 2 diabetes, metformin drugs will form additional effects: cardioprotection, oncoprotection, hepatoprotection, nephroprotection, additional hypoglycemic effect and will fight insulin resistance.