Is the ADA/EASD algorithm for the management of type 2 diabetes (January 2009) based on evidence or opinion? A critical analysis

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RESEARCH PRODUCT

Is the ADA/EASD algorithm for the management of type 2 diabetes (January 2009) based on evidence or opinion? A critical analysis

Bernard Charbonnel Roger Lehmann Valdis Pirags D. J. Betteridge Richard W. Nesto Agathocles Tsatsoulis Antonio Ceriello Markolf Hanefeld A. H. Barnett Ralph A. Defronzo R. Carmena Maciej T. Malecki André Scheen Guntram Schernthaner Jochen Seufert ÅKe Sjöholm

subject

cardiovascular risk Glucose-lowering therapy Endocrinology Diabetes and Metabolism education Societies Medical/standards MEDLINE 10265 Clinic for Endocrinology and Diabetology Hypoglycemic Agents/therapeutic use 610 Medicine & health Type 2 diabetes Hyperglycemia/drug therapy Lifestyle modification Risk Factors Diabetes mellitus Tier 2 network ADA Consensus Statement medicine Internal Medicine Initial treatment Hyperglycaemia Humans In patient For Debate algorithm business.industry nutritional and metabolic diseases Type 2 diabetes medicine.disease Cardiovascular risk United States Metformin EASD consensus statement glucose-lowering therapy Algorithm Europe 2712 Endocrinology Diabetes and Metabolism 2724 Internal Medicine *Algorithms Diabetes Mellitus Type 2/complications/*drug therapy type 2 diabetes business Algorithm Cardiovascular Diseases/prevention & control hyperglycaemia medicine.drug

description

The ADA and the EASD recently published a consensus statement for the medical management of hyperglycaemia in patients with type 2 diabetes. The authors advocate initial treatment with metformin monotherapy and lifestyle modification, followed by addition of basal insulin or a sulfonylurea if glycaemic goals are not met (tier 1 recommendations). All other glucose-lowering therapies are relegated to a secondary (tier 2) status and only recommended for selected clinical settings. In our view, this algorithm does not offer physicians and patients the appropriate selection of options to individualise and optimise care with a view to sustained control of blood glucose and reduction both of diabetes complications and cardiovascular risk. This paper critically assesses the basis of the ADA/EASD algorithm and the resulting tiers of treatment options. Diabetologia

year	journal	country	edition	language
2010-03-01

10.5167/uzh-44492 https://doi.org/10.5167/uzh-44492