Type 2 diabetes: the first step in treatment

In 70 % of cases, diabetes is detected and treated on an outpatient basis at the primary level of medical care by general practitioners and general practitioners. Type 2 diabetes mellitus, which accounts for 90–95 % of all cases of diabetes in the structure of morbidity, is a disease of malnutrition and an unhealthy lifestyle. The 2020 American Diabetes Association Recommendations noted that type 2 diabetes is always preceded by prediabetes, which should be considered as a factor in the increased risk of developing both diabetes itself and cardiovascular diseases. Therefore, preventive treatment should begin already at the stage of prediabetes, when cardiovascular complications of the future disease are formed. Lifestyle modification (diet, increased physical activity) in combination with taking metformin reduces the likelihood of transition of diabetes to diabetes by almost 90 %.The global goal of treating patients with type 2 diabetes is to address cardiovascular risks, taking into account the assessment of heart failure and renal function. The combination of metformin and sulfonylurea preparations shows a cardio- and nephroprotective effect and is therefore the most frequent combination in the world recommended for use as the first or second stages of treatment for patients with type 2 diabetes. When initiating a hypoglycemic therapy, immediate release metformin should be preferred.