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progressive disease with abN relationship between increasing insulin resistance and decreasing beta cell function so relative insulin insufficiency
4.45% of Uk population are diabetic, 90% of which is type 2
Target of HbA1C - NICE 48mmol/l(6.5%), SIGN 53 (7.0%) QOF 59 (7.5%) - so set practical personal target

First line
if >48 after lifestyle advice - ''Metformin mono'' - 

Consider ''sulphonylurea'' if ...
{{indent{not overweight
{{indent{need for rapid Rx of hyperglyc Sx}}}
{{indent{Metformin CI}}}

If overweight and Metformin CI - use ''Glitazones''

''If despite Metformin mono, HbA1C remains high'',
Add in Sulphonylurea eg Gliclazide

If risk of hypo or SE to sulphonylurea, add in Pioglitazone or Sitagliptin

If despite Metformin plus sulphonylurea, HbA1C remains high....
add insulin, sitagliptin or exenatide depending on weight and social/recreational/employment issues (or Pioglitazone)

''Acarbose'' - oral agent but use limited by GI SE

''Statins''
If <40 yr and no other risk factors then no
If >40yr and CVS risk <20% then no
both unlikely so normally will need
risk factors - overweight, HT, microalbuminuria, smokes, high risk lipids, FH, CVD