What are the treatment options for T2DM hyperglycemia?
Clinicians now have a range of effective agents to choose from when treating T2DM hyperglycemia. While metformin remains the initial treatment of choice, the alternatives in cases of intolerance or contraindication are many.
What is the latest update to manage hyperglycemia in type 2 diabetes?
2019 update to: management of hyperglycemia in type 2 diabetes, 2018. A consensus report by the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD) . 37. . . 38.
Which medications are used to treat type 2 diabetes mellitus (DM)?
Scranton R, Cincotta A. Bromocriptine – unique formulation of a dopamine agonist for the treatment of type 2 diabetes. Expert Opin Pharmacother. 2010;11:269–279.
When should insulin be added to the treatment of hyperglycemia?
• The early introduction of insulin should be considered if there is evidence of ongoing catabolism (weight loss), if symptoms of hyperglycemia are present, or when A1C levels (>10% [86 mmol/mol)] or blood glucose levels (≥300 mg/dL [16.7 mmol/L)] are very high.
What are the factors to consider when selecting another agent in lieu of metformin?
There are numerous factors to consider when selecting another agent in lieu of metformin including, but not limited to, overall efficacy in A1creduction, adverse effect profile, cost, and patient preference.
What is the best medication for diabetes?
The American Diabetes Association/European Association for the Study of Diabetes recommend a sulfonylurea, meglitinide, pioglitazone, or dipeptidyl pep tidase 4 (DPP-4) inhibitor when metformin cannot be used.3They also recommend using a glucagon-like peptide-1 (GLP-1) agonist if weight loss is warranted.
Is metformin a monotherapy?
Introduction. Metformin has long been considered the initial drug therapy choice in the treatment of type 2 diabetes mellitus (T2DM). The most widely recognized clinical guidelines and consensus recommendations endorse its use when monotherapy is initially preferred to treat hyperglycemia.1–4However, treatment with metformin is not suitable ...
Does Colesevelam reduce cholesterol?
As expected, colesevelam did show a reduction in low-density lipoprotein cholesterol (12%–16%). Colesevelam is not widely available as a generic medication and is more expensive than the generic agents used to treat T2DM. Colesevelam has a low risk of hypoglycemia. The most common adverse reaction is constipation.
Can metformin be used for renal impairment?
If a patient cannot receive metformin due to significant renal impairment (creatinine clearance <45 mL per minute), use of canagliflozin should also be avoided. DPP-4 inhibitors. Over the past few years, there have been numerous DPP-4 inhibitors approved for use in the treatment of hyperglycemia associated with T2DM.
Can you take metformin with gastrointestinal problems?
Patients may initially receive metformin but not be able to tolerate common side effects, mainly its gastrointestinal adverse effects. Likewise, some practitioners may be cautious in using metformin in patients at risk for but who do not necessarily currently have specific contraindications to its use.
Is metformin a drug?
Abstract. Metformin is considered an initial drug of choice for type 2 diabetes mellitus by leading recommendations. When contraindications to its use exist or patients cannot tolerate it due to adverse effects, clinicians have a variety of other classes of agents to treat hyperglycemia associated with type 2 diabetes mellitus.
PHARMACOLOGIC THERAPY FOR TYPE 1 DIABETES
9.1 Most people with type 1 diabetes should be treated with multiple daily injections of prandial and basal insulin, or continuous subcutaneous insulin infusion. A
SURGICAL TREATMENT FOR TYPE 1 DIABETES
Pancreas and islet transplantation normalizes glucose levels but requires life-long immunosuppression to prevent graft rejection and recurrence of autoimmune islet destruction.
PHARMACOLOGIC THERAPY FOR TYPE 2 DIABETES
9.5 Metformin is the preferred initial pharmacologic agent for the treatment of type 2 diabetes. A