Type 2 diabetes.

Type 2 diabetes accounts for nearly 90% of the approximately 537 million cases of diabetes worldwide. The number affected is increasing rapidly with alarming trends in children and young adults (up to age 40 years). Early detection and proactive management are crucial for prevention and mitigation of microvascular and macrovascular complications and mortality burden. Access to novel therapies improves person-centred outcomes beyond glycaemic control. Precision medicine, including multiomics and pharmacogenomics, hold promise to enhance understanding of disease heterogeneity, leading to targeted therapies. Technology might improve outcomes, but its potential is yet to be realised. Despite advances, substantial barriers to changing the course of the epidemic remain. This Seminar offers a clinically focused review of the recent developments in type 2 diabetes care including controversies and future directions.

Copyright © 2022 Elsevier Ltd. All rights reserved.

Declaration of interests EA has received fellowship funding from AstraZeneca. SL has been a member on advisory boards or has consulted with Merck Sharp & Dohme, and NovoNordisk. He has received grant support from AstraZeneca, Merck Sharp & Dohme, and Astellas. He has also served on the speakers' bureau of AstraZeneca, Boehringer Ingelheim, Eli Lilly & Co, Merck Sharp & Dohme, Chong Kun Dang Pharmaceutical, and Novo Nordisk. RL has received a research grant from Novo Nordisk. She has also received funds for serving on an advisory board for Sanofi and consultancy fees from Sanofi, AstraZeneca, Novo Nordisk, and Boehringer Ingelheim. DRW has received honoraria as a speaker for AstraZeneca, Sanofi-Aventis, and Lilly, and received research funding support from Novo Nordisk. MJD has acted as consultant, advisory board member, and speaker for Boehringer Ingelheim, Lilly, Novo Nordisk, and Sanofi; an advisory board member and speaker for AstraZeneca; an advisory board member for Janssen, Lexicon, Pfizer, and ShouTi Pharma; and as a speaker for Napp Pharmaceuticals, Novartis, and Takeda Pharmaceuticals International. She has received grants in support of investigator and investigator-initiated trials from Novo Nordisk, Sanofi-Aventis, Lilly, Boehringer Ingelheim, AstraZeneca, and Janssen.