PMID: 25796755Mar 24, 2015Paper

How I treat...The choice between a sulphonylulrea and a gliptin to manage hyperglycaemia in type 2 diabetes

Revue médicale de Liège
André J Scheen

Abstract

The pharmacological therapy of hyperglycaemia in type 2 diabetes becomes increasingly complex. After failure of metformin monotherapy, several choices are possible. In clinical practice, the most common dilemma is to choose between adding a sulphonylurea or adding a dipeptidyl peptidase-4 inhibitor (gliptin). This review analyses the arguments in favour of one or the other pharmacological option, based upon criteria of efficacy, tolerance, safety, easiness of use, use in at risk populations and, last but not least, cost of therapy. In general, a patient-centered approach is recommended with an individualization of the therapy in function of the characteristics of each patient with the aim to obtain the best benefits/ risks ratio, at an affordable cost.

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