Physicians now have an amazing array of drug therapies for control of type 2 diabetes. Until now, there has been no consensus as to which drugs to use, and when.
The American Association of Clinical Endocrinologists and the American College of Endocrinology have just issued a joint statement with specific drug recommendations. Their algorithm is quite detailed. Here are a few highlights you might not know about:
- Regular human insulin is not recommended
- NPH insulin is not recommended
- The following should be used earlier and more frequently: GLP-1 agonists (exenatide) and DPP-4 inhibitors (sitagliptin and saxagliptin)
- sulfonylureas are a lower priority
- metformin is still a key drug
In the U.S., exenatide is sold as Byetta; sitagliptin is Januvia; saxagliptin is Onglyza; metformin is Glucophage (among others).
If you have type 2 diabetes and are arguing with your physician about optimal drug therapy, this treatment algorithm may be a helpful tie-breaker.
Reference: Statement by an American Association of Clinical Endocrinologists/American College of Endocrinology consensus panel on type 2 diabetes mellitus: An algorithm for glycemic control. Endocrine Practice, 15 (2009): 540-559.