Current guidelines for treatment of type 2 diabetes: Are we pushing the limits of the evidence base?

In India we face several peculiar challenges in management of diabetes which need to be addressed while the management pattern is advised for a person with diabetes. The burden of diabetes is large, and the phenotypic variations are many. Generally, Indians develop type 2 diabetes (T2DM) at a younger age and with lower body mass index (BMI) than in the western countries, many tend to have comorbidities due to delayed diagnosis or negligent treatment. Generally the public and the patients have poor awareness regarding the chronic nature of the disease, the risk of developing complications and also the need to have lifelong control of glycaemia. Cost of diabetes is a barrier for obtaining the desired treatment goals. Therefore, a physician treating diabetes in India needs to individualize the management regimen taking the patient's social and economic background as well.