The American College of Physicians (ACP) has issued an update of its clinical practice guideline for the oral pharmacologic treatment of type 2 diabetes (T2D). Evaluated interventions included metformin, thiazolidinediones, sulfonylureas, dipeptidyl peptidase-4 (DPP-4) inhibitors, and sodium–glucose cotransporter-2 (SGLT-2) inhibitors. The guideline serves as an update to the 2012 ACP guideline and provides clinical recommendations on the topic, including:
- ACP recommends that clinicians prescribe metformin to patients with type 2 diabetes when pharmacologic therapy is needed to improve glycemic control. (Grade: strong recommendation; moderate-quality evidence)
- ACP recommends that clinicians consider adding either a sulfonylurea, a thiazolidinedione, an SGLT-2 inhibitor, or a DPP-4 inhibitor to metformin to improve glycemic control when a second oral therapy is considered. (Grade: weak recommendation; moderate-quality evidence.) ACP recommends that clinicians and patients select among medications after discussing benefits, adverse effects, and costs.
References:
- 2017 American Diabetes Association Standards of Medical Care in Diabetes. Diabetes Care. 2017;40(Supplement 1). doi:10.2337/dc17-S001.