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2014糖尿病指南:二型糖尿病的药物治疗Pharmacologic Therapy for Type 2 Diabetes

(2014-10-15 11:08:12) 下一个
2014糖尿病指南:二型糖尿病的药物治疗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
 
 
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