Diabetes Pathophysiology and Treatment Strategy Updates
Type 2 diabetes management continues to evolve as new evidence refines understanding of individualised glycaemic targets and treatment sequencing. This section explores the pathophysiological basis of diabetes alongside contemporary approaches to treatment intensification, including the role of insulin and injectable therapies. Content is designed to support South African primary care physicians, endocrinologists and diabetes educators in applying current evidence to everyday practice. Topics span from foundational disease mechanisms to practical management scenarios.
Science in Diabetes
KOL video 1 - Pr Steven Edelman - EASD 2024
video of Pr Steven Edelman answering to the question: How has Toujeo®’s wall of evidence across diverse diabetes patient populations and situations helped to inform your clinical decision making?
Dr. Alice Cheng on Basal Insulin & Toujeo® After GLP-1 RA Therapy | EASD 2024
Perspectives on basal insulin use post-GLP-1 RA, EASD, Dr Alice Cheng
Dr Alice Cheng KOL video 5 EASD 2024
What for you are the key findings of the Toujeo® pooled analysis?
Dr Alice Cheng KOL video 8 EASD 2024
In what way does the evidence for Toujeo® help you to address the considerations for patients who are inadequately controlled on a GLP-1 receptor agonist?
Dr Alice Cheng KOL video 7 EASD 2024
What would you say is the value of the findings in the Toujeo® pooled analysis and the DELIVER-G study when you consider the management of your patients with type 2 diabetes who are inadequately controlled on GLP-1 receptor agonist?
Real-World Outcomes of Switching to iGlarLixi (Soli-Switch Study)
The Soli-Switch Study evaluates the real-world effectiveness and safety of switching adults with type 2 diabetes from basal insulin or GLP-1 RA therapy to iGlarLixi (insulin glargine 100 U/mL plus lixisenatide). The study explores glycaemic control, treatment adherence, and patient outcomes in clinical practice settings.
Switching from Human Insulin to an Analogue – InConversation
Explore the clinical considerations and practical implications of switching people living with diabetes (PWD) from human insulin to analogue insulin. This discussion highlights the rationale for switching, including clinical indications, availability, and access challenges.
Type 2 diabetes involves progressive insulin resistance combined with declining beta-cell function over time, leading to worsening glycaemic control despite ongoing treatment. This progressive nature often necessitates treatment intensification beyond initial oral therapy as the disease advances. Understanding this trajectory supports proactive rather than reactive treatment planning. Early and appropriate intensification can help reduce long-term complication risk associated with sustained hyperglycaemia.
Treatment intensification typically progresses from lifestyle modification and initial oral therapy toward combination oral agents, and eventually to injectable therapies including GLP-1 receptor agonists or insulin as needed. The specific pathway depends on individual patient factors, including comorbidities, weight considerations and hypoglycaemia risk. Recognising the appropriate timing for each escalation step is a key focus of ongoing clinical education. Delayed intensification can prolong exposure to inadequate glycaemic control.
Individualised glycaemic targets account for factors such as patient age, comorbidities, disease duration and hypoglycaemia risk, rather than applying a uniform target to all patients. This approach balances the benefits of tight glycaemic control against the risks of over-treatment in vulnerable patients. Individualised targets also inform decisions around treatment intensity and monitoring frequency. This principle is increasingly reflected in contemporary diabetes management guidance.
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