The American College of Physicians has issued updated guidance on managing type 2 diabetes with oral antidiabetic drugs (OADs).
The guideline includes a systematic review of the evidence on efficacy regarding various comparisons of monotherapy and combined therapy.
- Comparative Effectiveness of Type 2 Diabetes Medications on Intermediate Outcomes
- Comparative Effectiveness of Type 2 Diabetes Medications on Long-Term Clinical Outcomes
- Comparative Safety of Type 2 Diabetes Medications
- Comparative Effectiveness of Type 2 Diabetes Medications Across Subgroups of Adults Aged 65 Years or Older
- ACP Best Practice Advice
- ACP recommends that clinicians add oral pharmacologic therapy in patients diagnosed with type 2 diabetes when lifestyle modifications, including diet, exercise, and weight loss, have failed to adequately improve hyperglycemia.
- ACP recommends that clinicians prescribe monotherapy with metformin for initial pharmacologic therapy to treat most patients with type 2 diabetes.
- ACP recommends that clinicians add a second agent to metformin to treat patients with persistent hyperglycemia when lifestyle modifications and monotherapy with metformin fail to control hyperglycemia.
- Does this guidance conform to AGREE principles? Although the publication reports a systematic search for evidence, other key aspects of the guideline development process are not described.
Qaseem A, Humphrey LL et al. Oral pharmacologic treatment of type 2 diabetes mellitus: a clinical practice
guideline from the American College of Physicians. Ann Intern Med. 2012 Feb 7;156(3):218-31. 22312141