This new publication provides guidance for clinicians on the comparative effectiveness and safety of type 2 diabetes medications.
The guidance applies to adults over 18 years of age and does not cover combinations of more than two drugs.
- The 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 (Grade: strong recommendation; high-quality evidence).
- The ACP recommends that clinicians prescribe monotherapy with metformin for initial pharmacologic therapy to treat most patients with type 2 diabetes (Grade: strong recommendation; high-quality evidence).
- The 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 (Grade: strong recommendation; high-quality evidence).
Users of this guidance should consider:
- Conformance with AGREE principles of guideline development
- Applicability of the guidance in your setting.
The guidance is available full text from the Annals of Internal Medicine.
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;156:218-231.