Combination Glucose-Lowering Therapy Plans in T2DM: Case-Based Considerations

Advances in Therapy
Lawrence BlondeDaniel Cadena

Abstract

Type 2 diabetes mellitus (T2DM) is a complex disease, and while lifestyle interventions remain the cornerstone of therapy, most patients will also require pharmacotherapy. Current diabetes treatment guidelines and algorithms recommend an individualized approach to setting glycemic goals and selecting treatment. Although a single antihyperglycemic agent may be appropriate as the initial T2DM pharmacotherapy, the progressive nature of the disease due to declining pancreatic β-cell function will result in the vast majority of T2DM patients eventually requiring two or more antihyperglycemic agents. The American Association of Clinical Endocrinologists/American College of Clinical Endocrinology T2DM management algorithm recommends initial dual agent combination therapy when a single agent is unlikely to achieve their target glycemia, i.e., for those patients with an HbA1c ≥ 7.5 and an individualized HbA1c target of < 7.5%. The American Diabetes Association Standards of Care recommend combination pharmacotherapy for those patients presenting with very elevated HbA1c levels (e.g., ≥ 9% and < 10%). Metformin (if well tolerated and not contraindicated) is the initial pharmacologic choice for most patients; selection of another antihyper...Continue Reading

References

Oct 19, 2005·Annals of Internal Medicine·Robert J HeineUNKNOWN GWAA Study Group
Dec 6, 2006·The New England Journal of Medicine·Steven E KahnUNKNOWN ADOPT Study Group
Jan 30, 2009·Diabetes, Obesity & Metabolism·C J Bailey, C Day
Aug 19, 2009·Diabetologia·D Russell-JonesUNKNOWN Liraglutide Effect and Action in Diabetes 5 (LEAD-5) met+SU Study Group
Sep 8, 2009·Journal of the American Board of Family Medicine : JABFM·Richard W GrantJohn B McKinlay
Feb 5, 2011·Postgraduate Medicine·Serge Jabbour, Barry Ziring
Jan 25, 2012·Advances in Therapy·Lawrence Blonde, Zinnia T San Juan
Oct 27, 2012·Diabetes Care·M Sue KirkmanCarrie S Swift
Jun 13, 2013·Endocrine Practice : Official Journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists·Samuel S EngelBarry J Goldstein
Jul 16, 2013·Journal of Diabetes and Its Complications·Kristina M JohnssonJames F List
Sep 3, 2013·The New England Journal of Medicine·Benjamin M SciricaUNKNOWN SAVOR-TIMI 53 Steering Committee and Investigators
Feb 28, 2014·The New England Journal of Medicine·Amy G EganCurtis Rosebraugh
Apr 17, 2014·Diabetes Research and Clinical Practice·Farhad M HasanJohn E Gerich
Apr 18, 2014·The New England Journal of Medicine·Edward W GreggLinda Geiss
Aug 16, 2014·European Journal of Clinical Pharmacology·Xu-Ping YangYi-Lan Huang
Oct 18, 2014·Diabetes, Obesity & Metabolism·J B BuseM Diamant
Nov 27, 2014·Diabetes Therapy : Research, Treatment and Education of Diabetes and Related Disorders·Sanjay Kalra
Jan 30, 2015·Expert Opinion on Drug Safety·André J Scheen

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