Type 2 diabetes as a prominent global health issue: A narrative review

Diabetes is one of the most prevalent non-communicable diseases worldwide which can lead to significant macrovascular and microvascular complications. A majority of patients with diabetes suffer from type 2 diabetes and its prevalence and incidence continue to increase globally. Its underlying pathophysiology is complicated. Both genetic predisposition and lifestyle risk factors can result in relative insulin deficiency and the development of type 2 diabetes. Patients with type 2 diabetes can present with polyuria, polydipsia, polyphagia, blurred vision, and recurrent infections. However, many patients may be initially asymptomatic, resulting in late diagnosis. Delayed diagnosis can also result in presenting with already established complications at the time of diagnosis. There are various diagnostic methods and these include measurements of glycated hemoglobin, fasting plasma glucose, or random plasma glucose together with classical signs and symptoms of hyperglycemia. Alternatively, an oral glucose tolerance test can be carried out to confirm the diagnosis. Lifestyle modification and pharmacotherapy are the backbones of type 2 diabetes treatment. Metformin is considered to be the first-line therapy of choice. However, if the desired glucose control is not achieved, then metformin is combined with other anti-diabetic medications. As type 2 diabetes is largely a preventable disease, its primary prevention is of utmost significance. The aim of primary prevention is to reduce the modifiable risk factors such as obesity, unhealthy diet, physical inactivity, and smoking.