Adherence and the contemporary approach to treating type 2 diabetes mellitus

Introduction: In addition to lifestyle changes, the treatment of type 2 diabetes mellitus also implies early introduction of pharmacological therapy. Aim: The main goal of this paper was to present the contemporary approach to treating this chronic, progressive disease and to indicate the importance of adherence in treatment outcomes. Methods: Analysis and synthesis of the results of previous research. Key findings: The treatment of type 2 diabetes mellitus should be conducted by a team of experts in collaboration with the patient, who plays a central role in the treatment, with all their characteristics and preferences. Education and involving the patient in treatment, encouraging self-care, are crucial. A healthy lifestyle (medical nutritional therapy, physical activity, weight control) remains the foundation of the treatment, and if that is not sufficient, early pharmacotherapy is initiated. Medications have been developed to lower blood sugar level with cardiorenal protection, such as sodium-glucose cotransporter-2 inhibitors and glucagon-like peptide 1 receptor agonists, as well as drugs that have a favourable impact on non-alcoholic fatty liver disease and non-alcoholic steatohepatitis, such as pioglitazone. Unfortunately, patient adherence to the agreed treatment regimen is often poor. Factors associated with poor adherence are diverse and often multiple in a particular patient. Discussion: Many patients may benefit from cardiorenal-protective glucose-lowering medications; however, due to their still high cost, metformin remains the drug of first choice for most patients. Poor adherence to the therapeutic plan is associated with poor glycaemic control, increased risk of disease complications, increased cardiovascular risk, increased mortality, hospitalizations, and healthcare costs. In addition to reducing the complexity of drug therapy and better informing the patient, improved education and motivation could lead to better adherence. Enhanced communication between the patient and the physician and ...