Early therapy for type 2 diabetes in China

Diabetes is a huge burden in China, where about 100 million people have been diagnosed with the disease. Treatments are needed that are optimal for treating Chinese patients with diabetes. Chinese patients with type 2 diabetes are characterised by having relatively low bodyweight and significant beta-cell deterioration. beta-cell failure results in deficiency of insulin secretion, particularly at the early phase of insulin secretion in Chinese patients. As a result, postprandial hyperglycaemia is more pronounced in Chinese patients with early type 2 diabetes than most other ethnic groups. These characteristics point to the key strategies when considering early therapy for Chinese patients with type 2 diabetes, including control of postprandial hyperglycaemia and beta-cell preservation. Besides metformin, insulin secretagogues and a-glucosidase inhibitors that target postprandial hyperglycaemia are recommended for drug-naive patients. Short-term intensive insulin therapy is suggested for patients with severe hyperglycaemia at diagnosis to help restore beta-cell function. Use of incretin-based drugs is also recommended when treatment fails with metformin, insulin secretagogues, and a-glucosidase inhibitors. Although data on antidiabetic drugs in Chinese patients are growing, there are still gaps in the evidence base. Research is needed to strengthen the evidence-based treatment guidelines for Chinese patients with type 2 diabetes.