Introduction
Before Going to Main Topic What do Mean By Simple: Simple means Easy, uncomplicated, effortless, painless, manageable, unfussy, nononsense, basic, modest, unsophisticated, honest, homely Disease. But many Physicians are telling it is a serious disease more than Leprosy & Cancer. For Which In Western country Kept Under "Disable Disease". Why You Will tell a "disable disease". For Example, I am having more than 20Years Diabetes. All my Parameters are within Normal range. I am Physically, Mentally and Sexually very Sound. Why  you will tell me "Disable". Cut the Word" Dis" My Advice to Organization It is an "ABLE DISEASE"

Serious Disease Means
Important, significant, consequential, momentous, of moment, key, grave, weighty, far-reaching, major & severe in effect disease. Diabetes mellitus (DM) is probably one of the oldest diseases known to man. Type 2 DM (formerly known as non-insulin dependent DM) is the most common form of DM characterized by hyperglycemias, insulin resistance, and relative insulin deficiency. Type 2 DM results from interaction between genetic, environmental, Nutritional  and behavioural risk factors. living with type 2 DM are more vulnerable to various forms of both short- and long-term complications, Insidious onset and late recognition, especially in resource-poor developing countries, Wrong diet plan(My View) example advising Mango, Orange which I differed rather Even I used advise "Stop sugar based Fruits even Apple,Pumpgrnate,grapes,Banana,Orange,Jagery" .I used to compare Apple Vs Tomato. Even I am having 21 Years of Diabetes Even I have never taken "one Apple "But I am Physically, Mentally and Sexually sound. My HBA1C is always 5.7 to 5.9.I used advice One Guava weekly once, Avocado Regularly,8(4+4) Almonds,Walnuts,Strawberry. Treatment for type 2 diabetes includes monitoring your blood sugar levels and using medications or insulin when needed. I recommend losing weight through diet and exercise that is VLCD(Very Low Calorie Diet) with My Diet Plan. All of My Patient having HBA1C between 5.7 to 6.2. With my diet plan  all patient to come first 3month.If FBS,PPBS,HBA1C,Lipid Profile,LFT,KFT and Eye Test (Fundoscopy) is within normal. I used to tell them come Every two Consecutive 6 Months. If it is Normal. Then I used to Do the test in Their Place with that test if It is normal or HBA1C Less than 5.5.I used to reduce my drugs.

EARLY INSULIN THERAPY I DIFFERED IN TYPE II DIABETESI am requesting all the physician of the world not to start insulin initially in type ii diabetes as EIT I deferred as because:-(1)Insulin Word makes a patient panic(2)Hypoglycaemia(3)Obesity(4)Insulin Resistance(5)All most 90% Patients are under OHD. Even i am taking for last 17years with triple combination. My HBA1C 5.7 to 5.8(6)INCREASE IN TG LEVEL(7)INSULIN VS OHD BETA CELL FAILURE NO EFFECT.(8) Insulin may increase ESRD risk in type 2 diabetes, study finds(VERY IMPORTANT)Type 2 diabetes patients who were insulin users had an increased risk of end-stage renal disease, regardless of their A1C levels, compared with those not taking the drug, according to a study presented at an American Society of study shows.
I do not agree about life expectancy 10-20years. I used to advice a Controlled Type 2 Diabetes will live longer than a Non-Diabetic. Thus I do not agree with It is a Progressive Disease rather than a Nutritional and Environmental Disorder.

Epidemiology
It is estimated that 366 million people had DM in 2011; by 2030 this would have risen to 552 million. But my View it can be reduce by My Medications like simple drug like Glimiperide,Metformin,Voglibose,Pioglitazone(Cardio-Reno-Hepato-Neuro protective),and teneligliptin,Vildagliptin. along with my VLCD and My Diet Plan. No newer drug or Insulin I have given Only 1.5% needs Insulin.Not Degludac (ultralong-acting basal insulin analogue ), SGLT2 inhibitors or Glucagon-like peptide-1 receptor agonists Which are cost effective and Produce another disease may be fatal. But in all type II diabetes I used to put on my Diet plan and VLCD.There is tremendous result. Firstly Medicines low cost, No panic for any serious side effects like Hypoglycemia,Serious Mycotic Infection with Gangrene, Pancreatitis or any cancer.

First my drugs i advice:

• Glimepiride: -Low Price varies from Rs4-7,
•  low blood sugar (hypoglycemia). Symptoms may include trembling or shaking. nervousness or anxiety. irritability. sweating. lightheadedness or dizziness. headache. fast heart rate or palpitations. intense hunger. fatigue or tiredness.
• headache.
• nausea.
• dizziness.
• weakness.
• unexplained weight gain.

Benefits are:

• Controlling high blood sugar helps
• prevent kidney damage,
• No blindness,
• No nerve problems,
• No  loss of limbs,
• No sexual function problems

Metformin:

• Cost In India 70Paise to Rs1/Tablet
• Best Drug For Type 2 Diabetes
• Insulin Sensitizer
• Reduces Total Cholesterol and LDL
• Increases the Insulin Level
• Side Effects GI like Nausea, Vomiting
• Long Term Use can cause B12 Deficiency
• Weight loss
• Safest Drug in Diabetes

Voglibose:

• Cost one tabRs4-Rs5
• Reduces PPBS
• MAY CAUSE:
• Diarrhoea
• Flatulence
• Pneumatosis Intestinalis (Rare)
• Abnormal liver function (Rare)
• Nausea or vomiting
• Dizziness

Pioglitazone15Mg:

• Cost Rs2-3
• Benefits Cardio-Reno-Hepato-Neuro Protective
• Reduces PPBS
• Heart: Congestive heart failure. (Rare)
  
  • Eye and ENT: Inflammation of pharynx, swelling of the retina. (Rare with High dose) 
  •  Gastrointestinal: Tooth disorders. 
  •  Liver: Elevated liver enzymes, inflammation or damage of liver. 
  •  Blood: Anemia. (Rare with High dose)
• Metabolic: Low glucose level with symptoms of shakiness, dizziness, sweating, headache, pale skin, hunger. 
  •  Musculoskeletal: Bone fractures, muscle pain. 
  •  Respiratory: Upper respiratory tract infection, sinusitis. 
  •  Miscellaneous: Edema.
• (regarding bladder cancer i strongly oppose,even i have challanged to ada)

Teneligliptin:

• CostRs3-5

Advantages:

•  Improved 24 h blood glucose levels by increasing active incretin levels 
•  reducing the postprandial insulin requirement
• reducing glucagon secretion

Sideffects:

• Hypoglycaemia
• Constipation
• Nausea
• Loss of appetite
• Diarrhoea
• Abdominal pain
• Abdominal discomfort

Degludac:  ultralong-acting basal insulin 

• Cost in India Rs5048/=

BENEFITS

• offers much greater flexibility over when doses can be taken

DISADNANTAGES:

Common side effects of Tresiba include:

• low blood sugar (hypoglycemia),
• allergic reactions,
• injection site reactions,
• body fat redistribution (lipodystrophy),
• itching,
•  Long-term harms, particularly cancer, Cardiovascular Harm Can not be ruled out.
• Acute Pancreatitis
•  “TZDs” with Degludac Causes Sever Heart failure
• blurred vision
•  rash,
• swelling,
• weight gain,
• runny or stuffy nose,
• upper respiratory tract infection,
• headache,
• sinusitis,
• upset stomach or stomach pain, and
• diarrhoea.
• Hypokalemia
• trouble breathing, shortness of breath, fast heartbeat, swelling of your face, tongue, or throat, sweating, extreme drowsiness, 

(My View I Am Strictly Opposing This Drug Firstly Verycost Effective.Cumulative Effect Causes Sever Hypoglycemia,Uncertenty Producing Cancer,Cv Risk)

Glucagon-like peptide-1:

• Albiglutide (Tanzeum)
• Dulaglutide (Trulicity)
• Exenatide (Byetta)
• Extended release exenatide (Bydureon)
• Liraglutide (Victoza)Mainly Used
• Lixisenatide (Adlyxin)
• Semaglutide (Ozempic)
• Cost of Liraglutide Rs4840/=

Advantages:

• •  Induce and sustain weight loss
  • Additional studies are needed to determine its long-term efficacy and safety profile. (HUMANBEINGS ARE NOT GUINEPIG)
  • nausea
  •  itching
  • Raised bumps
• Diarrhoea
• Vomiting
• Headache

(My Opinion in Indian Setup Should Not Use)

SGLT2 Inhibitors:

• Cost in India one Tablet Rs51/=

Advantages:

• • canagliflozin, dapagliflozin, empagliflozin
  • Good  glucose control
  • Reduces Uric Acids
  • reductions in cardiovascular Mortality

DISADVANTAGES:

• • • genital Mycotic infections
    • Sever urinary tract infections 
    • risk of ketoacidosis
    • bone fractures 
    • deserves caution and further evaluation. (my view to indian physician then why we will advise)

Pathophysiology:
Type 2 DM is characterized by insulin insensitivity as a result of insulin resistance, declining insulin production, and eventual pancreatic beta-cell failure. In my  View it can be reversible by Nutrition like taking  Nutrition which Changes resistant Insulin to sensitive Insulin like Type 2 Diabetes Can get rid of Cardiovascular Risk not by GLP 1 OR SGLT-2 It can be achieved by Only Nutrition:-
1.Stop Polished rice(Lack of Beta Setosterol)
2.Avoid Oil(Dr Panda Prefers Olive Oil)
3.10Petals of Garlic ,One Onion per day. Garlic contains Allicin is thought to be the principal bioactive compound for prevention of cardiovascular and other metabolic diseases, atherosclerosis, hyperlipidemia, thrombosis, hypertension and diabetes.
4. Red bell peppers are rich in lycopene, thus making them excellent for a healthy heart whereas green bell peppers are a good source of cholesterol lowering fiber. Increased homocysteine levels can lead to a higher risk of heart disease. Bell peppers contain vitamin B6 and folate which help to lower homocysteine levels. In addition to these, the powerful antioxidants vitamins A and C present in these vegetables help to wipe out free radicals. Potassium contained in bell peppers lowers about 162 milligrams of blood pressure which is also beneficial for heart.
5.Curry Leaves (Murreya Koeniigi) Used as Antidiabetic drug and in CAD due to presence of Cinamaldehyde,Carbazole like Mahanimbin and girinimbin which produces Insulin and Converts Resistant Insulin to Sensitive Insulin. It clears the coronary artery blockade even it obliterates Calcification of Coronary artery. I do not agree it is an Progressive disease. How 30% Patients coming after years together  with minimising my Drugs. My view it is  "Nutritional and Environmental Disease.
Management:
Through lifestyle and diet modification diabetes can be reversed by VLCD,Simple Medications and  eating high fibre and unsaturated fat and diet low in saturated and trans-fats and glycemic index, regular exercise, abstinence from smoking and moderate consumption of alcohol.

Summary: Type 2 Diabetes is a Simple Chronic Disease making Panic to Innocent Patient can be treated with simple drug like Glimiperide,Metformin,Voglibose,Pioglitazone(Cardio-Reno-Hepato-Neuro protective),and teneligliptin. Out of more than 1.5 Lakhs Patients I could successful about 98%.No newer drug or Insulin I have given Only 1.5% needs Insulin.
Not Degludac (ultralong-acting basal insulin analogue ), SGLT2 inhibitors or Glucagon-like peptide-1 receptor agonists Which are cost effective and Produce another disease may be fatal. But in all type II diabetes I used to put on my Diet plan and VLCD.There is tremendous result. Firstly Medicines low cost, No panic for any serious side effects like Hypoglycemia,Serious Mycotic Infection with Gangrene, Pancreatitis or any cancer .I do not agree to ADA-EASD  Guideline.