What is the difference between the "octet" approach to Type 2 Diabetes Mellitus management compared to the "triumverate" approach?

Question

Traditionally, management of Type 2 DM follows a three prong approach: Diet, exercise, medications to achieve normal glycemic blood levels. The "octet" approach considers eight impaired body processes that simultaneously result in Type 2 DM. New medication classifications target the eight impaired body processes to achieve normal glycemic blood levels.

Answer 1

The appropriate treatment of Type 2 DM still includes the three traditional components of diet, exercise, and medications. This is the triumverate approach and the focus is achieving normal blood glucose levels, best measured by HbA1c. Conventional DM Type 2 medications include metformin, sulfonyureas, and insulin. Metformin depresses the breakdown of adipose tissue to liberate glucose. Sulfonyureas make the beta cells of the pancreas produce more insulin, and exongenous insulin causes the cells to uptake blood glucose. The end result is lowering of blood glucose and feeding the cells of the body.

The octet approach still uses diet, exercise and medications, but eight underlying impaired metabolic processes are identified and medication classifications including thiazolidinedione (TZD), GLP-1 analogs, and DPP4 inhibitors target impaired metabolic processes in the pancreas, the beta cells of the pancreas, the stomach, the intestines, adipose tissue, skeletal muscles, the brain, and the liver. Targeting a variety of the contributing impaired processes results in lowering blood glucose and feeding the cells of the body.