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2 Diabetes. 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.
The management of hyperglycemia in type 2 diabetes has become complex with the number of glucose-lowering medications now available. Patient-centered decision-making and support and consistent efforts at improving diet and exercise remain the foundation of all glycemic management.
Optimal A1C is ≤6.5%, or as close to normal as is safe and achievable. Therapy choices are patient centric based on A1C at presentation and shared decision-making. Choice of therapy reflects ASCVD, CHF, and renal status. Comorbidities must be managed for comprehensive care.
Staying up to date with the latest blood glucose–lowering medications is an important part of diabetes management. Check out our comprehensive chart to understand how your meds work, and keep the list handy for times when your health care provider suggests changes to your treatment plan. DRUG CLASS. HOW IT PRIMARILY WORKS.
24 Ιαν 2017 · Flow chart depicting an algorithm for use of drug regimen in treating diabetes mellitus Several concepts presented here are adapted from American Diabetes Association/European...
Simplified summary. HbA1c targets. Usual targets – NICE. 48 mmol/mol if treated with lifestyle alone, or a single drug. 53 mmol/mol if on a single drug associated with hypoglycaemia (insulin or SU). If on a single drug, the threshold for adding a second drug is HbA1c ≥58 mmol/mol. 53 mmol/mol on two or more drugs or insulin.
Assess the response of any drug at 3-6 months – if there is no reduction of at least 6mmol/mol in HbA1c in 6 months or weight loss if using GLP-1 or if there are any concerns regarding side effects stop the chosen medication and move to an alternative class.
