MOUNT SINAI JOURNAL OF MEDICINE 76:215, 2009 215
THEME INTRODUCTION
Type 2 Diabetes Mellitus:New Evidence, More Controversy
Dina Green, MD
Division of Endocrinology, Mount Sinai School of MedicineNew York, NY
The theme of this issue of the Mount SinaiJournal of Medicine is ‘‘New Evidence, MoreControversy.’’ Over the past 20 years, there has beenan accumulating body of evidence that treatmentof type 2 diabetes with meticulous blood glucosecontrol averts many of the dreaded microvascular andmacrovascular complications of the disease. As boththe prevalence of type 2 diabetes and the demandfor treatment have increased, many questions havearisen. These questions largely revolve aroundtreatment strategies for diabetes and the precise goalsof treatment.
This issue opens with a description of thepathophysiology of type 2 diabetes, with a particularfocus on the incretin hormones and their role inpotentiating insulin action. The incretin system hasrecently been harnessed to produce an entirely novelclass of antidiabetic agents: the incretin mimetics anddipeptidyl peptidase IV inhibitors. The mechanism ofaction and clinical utility of these drugs are discussedin detail in another review. Also of interest is adiscussion of other oral antidiabetic agents, includingthe thiazolidinediones, whose side effect profile hasrecently come under fire. The highlight of the issue isan elegant discussion of the recent literature that asks
Address Correspondence to:
Dina GreenDivision of Endocrinology
Mount Sinai School of MedicineNew York, NY
Email: [email protected]
what constitutes an optimal level of glycemic controland what degree of glycemic control is needed toavert long-term complications. Also of interest arereviews of the role of bariatric surgery, particularly asa long-term solution to diabetes, the role of nutritionalmanagement in diabetes, and the rising prevalenceof diabetes in pregnancy.
It is humbling to remember that only 90 yearsago Frederick Banting and Charles Best performedearly translational research when they successfullytreated type 1 diabetes with insulin and transformedthe natural history of the disease. In this issue, wealso highlight the importance in type 2 diabetesof translational medicine, that is, the concept ofapplying principles of basic science to further ourunderstanding of disease processes and treatmentstrategies. We can only hope that the work discussedhere and other discoveries emerging from thelaboratory will similarly transform our understandingof and treatment options for type 2 diabetes.
DISCLOSURES
Potential conflict of interest: Nothing to report.
Published online in Wiley InterScience (www.interscience.wiley.com).DOI:10.1002/msj.20108
2009 Mount Sinai School of Medicine
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