Recent guideline recommendations highlight the need to manage hyperglycemia alongside comorbidities and risk factors, rather than in isolation. Long-acting GLP-1 receptor agonists and SGLT-2 inhibitors are recommended for patients with cardiorenal risk factors due to their protective effects. A new algorithm for managing latent autoimmune diabetes in adults, based on glutamic acid decarboxylase and C-peptide testing, helps tailor treatment. Advances in diabetes care now focus on remission as a goal, emphasizing beta cell resilience and challenging the idea that type 2 diabetes inevitably progresses.

Despite the expansion of treatment options, many patients still fail to achieve target A1c levels. Primary care physicians are encouraged to adopt the latest strategies to improve outcomes. Precision medicine, which targets individual drivers of hyperglycemia, is gaining importance. This approach enables more effective management, reducing reliance on insulin and sulfonylureas. Early intervention, intensive management, and the use of pleiotropic medications like GLP-1 agonists and SGLT-2 inhibitors are critical to improving long-term outcomes.

Reference: Schwartz SS, Corkey BE, R Gavin J 3rd, DeFronzo RA, Herman ME. Advances and counterpoints in type 2 diabetes. What is ready for translation into real-world practice, ahead of the guidelines. BMC Med. 2024;22(1):356. doi: 10.1186/s12916-024-03518-5.