Introduction: In recent years, numerous pharmacological approaches for the treatment of
type 2 diabetes mellitus (T2DM) have become available. While all of them have proven blood glucose-lowering effects, identifying the most beneficial drug or drug combination for the treatment of
an individual patient has become an increasing challenge. Several guidelines attempt to provide decision
criteria based on clinical characteristics and comorbidities in patients with T2DM, however,
these guidelines still leave a broad range of capabilities for pharmacological treatment escalation.
Pathophysiological Approach: Addressing the pathophysiology of T2DM might be a valuable approach
for the selection and combination of different drugs that can provide the most comprehensive
effects in the treatment of T2DM. Besides decreasing insulin sensitivity, a progressing imbalance in
alpha and beta cell function of the Langerhans islet is a fundamental component in the complex
pathophysiology of the disease.
Conclusion: Considering the effect of different pharmacological interventions on the pathophysiological
components in T2DM might be an effective tool guiding to most beneficial treatments, and
may lead to a more tailored pharmacological intervention in patients with T2DM. .