2014糖尿病指南：二型糖尿病的藥物治療Pharmacologic Therapy for Type 2 Diabetes

2014糖尿病指南：二型糖尿病的藥物治療Pharmacologic Therapy for Type 2 Diabetes

Medications for Hyperglycemia in Type 2 Diabetes

Metformin
Preferred initial therapy (if tolerated and not contraindicated)
 

Consider insulin therapy with or without other agents →

At outset in newly diagnosed patients with markedly symptomatic and/or elevated blood glucose levels or A1C
 

Add 2nd oral agent, GLP-1 receptor agonist, or insulin →

If noninsulin monotherapy at maximal tolerated dose does not achieve or maintain A1C target over 3 mos
 

Choice of pharmacologic therapy should be based on patient-centered approach

Consider:

• Efficacy

• Cost

• Potential side effects

• Effects on weight

• Comorbidities

• Hypoglycemia risk

• Patient preferences

Insulin eventually needed for many patients due to progressive nature of type 2 diabetes
 

GLP=glucagon-like peptide