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Managing diabetes in Asia: overcoming obstacles and the role of DPP-IV inhibitors |
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| Authors: | Mu Yi-Ming Misra Anoop Adam John M F Chan Siew Pheng Chow Francis C C Cunanan Elaine Cheeay Deerochanawong Chaicharn Jang Hak Chul Khue Nguyen Thy Sheu Wayne H-H Tan Kevin E K |
| Institution: | a Department of Endocrinology, Chinese PLA General Hospital, Beijing, China b Fortis-C-DOC Centre of Excellence for Diabetes, Obesity, Metabolic Diseases and Endocrinology, Fortis Hospital, Vasant Kunj, New Delhi, India c Diabetes and Lipid Centre, Dr. Wahidin Sudirohusodo Hospital, Makassar, Indonesia d Department of Medicine, University of Malaya, Kuala Lumpur, Malaysia e Division of Endocrinology and Diabetes, Department of Medicine & Therapeutics, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong f University of Santo Tomas Hospital, Espana, Manila, Philippines g Diabetes and Endocrinology Unit, Department of Medicine, Rajavithi Hospital, Rangsit Medical School, Bangkok, Thailand h Department of Internal Medicine, Seoul National University, Bundang Hospital Seongnam, South Korea i Department of Endocrinology and Diabetes, University of Medicine and Pharmacy, Ho Chi Minh City, Viet Nam j Division of Endocrinology and Metabolism, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan k Mount Elizabeth Medical Centre, Singapore |
| Abstract: | Asia bears the world's greatest burden of type 2 diabetes (T2DM) and prevalence is increasing rapidly. Compared to other races, Asians develop T2DM younger, at a lower degree of obesity, suffer longer from its complications and die earlier. Curbing this epidemic requires an integrated, risk-based, and multidisciplinary approach. Inadequately managed T2DM has macrovascular and microvascular sequelae, Asians with T2DM being particularly susceptible to diabetic nephropathy. Earlier and more intensive monitoring and management of risk factors are required, especially for patients with, or at risk of, renal impairment. Particular challenges of T2DM management in Asia include: lack of access to specialist healthcare, insufficient clinical evaluation and delayed diagnosis. As in Caucasians, conventional treatment modalities are limited by deteriorating glycaemic control with disease progression and there is an unmet need for efficacious, safe, cost-effective and convenient pharmacotherapies for treating different stages of T2DM and preventing its complications, particularly in high-risk patients. There is a trend towards increasing use of DPP-IV inhibitors, which are no less efficacious and safe in Asians than Caucasians and may have some advantages over existing oral antidiabetic agents, particularly for certain high-risk groups. Such agents may play a significant future role in the management of T2DM. |
| Keywords: | Asia Diabetes Guidelines Kidney Management Nephropathy Renal |
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