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Type 2 Diabetes Mellitus: The Importance of Early and Personalised Management
Type 2 diabetes mellitus (T2DM) is a chronic, complex, and progressive disease affecting millions of people worldwide and representing one of the major public health challenges. The disease is characterised by a combination of insulin resistance and progressive deterioration of pancreatic β-cell function, resulting in increased blood glucose levels. If not adequately controlled, chronic hyperglycaemia promotes the development of microvascular and macrovascular complications, which are associated with a significant reduction in quality of life and life expectancy¹⁻⁴.
In recent years, advances in the understanding of the pathophysiology of type 2 diabetes and the availability of new therapeutic options have profoundly changed the approach to disease management. The goal of treatment is no longer limited to achieving a target glycated haemoglobin (HbA1c) value, but rather involves comprehensive patient care aimed at reducing cardiovascular and renal risk, preserving organ function, limiting the risk of hypoglycaemia, supporting body weight management, and improving quality of life¹,².
The most recent international recommendations emphasise the importance of personalised therapy, tailored to the patient's clinical characteristics, comorbidities, age, cardiovascular and renal risk profile, and shared treatment goals¹,². In this context, lifestyle interventions, including a balanced diet, regular physical activity, and maintenance of an appropriate body weight, represent essential components of the therapeutic pathway and should accompany every stage of disease management.
A key concept in current diabetes management is the importance of early therapeutic intervention. Available evidence demonstrates that achieving good metabolic control during the early stages of the disease is associated with clinical benefits that persist over time, a phenomenon known as metabolic memory. Reducing exposure to hyperglycaemia at an early stage can therefore help decrease the cumulative risk of complications and improve long-term prognosis⁴.
The management of type 2 diabetes mellitus therefore requires a dynamic and multidisciplinary care pathway. Early diagnosis, the definition of personalised therapeutic targets, regular monitoring, and timely treatment intensification when clinically appropriate are essential elements to reduce the burden of complications and ensure a better quality of life for people living with diabetes.
References
1. American Diabetes Association Professional Practice Committee. Standards of Care in Diabetes—2025. Diabetes Care. 2025;48(Suppl 1).
2. Davies MJ, Aroda VR, Collins BS, et al. Management of Hyperglycaemia in Type 2 Diabetes, 2022. A Consensus Report by the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD). Diabetologia. 2022;65:1925-1966.
3. Saeedi P, Petersohn I, Salpea P, et al. Global and regional diabetes prevalence estimates for 2021 and projections for 2045. Diabetes Res Clin Pract. 2021;183:109119.
4. Holman RR, Paul SK, Bethel MA, Matthews DR, Neil HAW. 10-year follow-up of intensive glucose control in type 2 diabetes. N Engl J Med. 2008;359:1577-1589.
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