Insulin resistance effects the oral hypoglycemic medication you choose.
The earlier we address insulin resistance, the earlier we address cardiovascular risk. Instead of sulphonylurea, begin with metformin, which addresses insulin resistance. It should also imply starting metformin as soon as possible and not waiting more than three months after beginning diet treatment before acting pharmacologically. There is a growing case for starting metformin at diagnosis since it tackles the entire cardiovascular risk rather than simply hyperglycemia. UKPDS provides scientific support for metformin's cardiovascular preventive impact. Patients on metformin had a decreased risk of myocardial infarction than those receiving extensive therapy with sulphonylureas or insulin (UKPDS, 1998).
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