1. Copyright © 2015 by the American Osteopathic Association.
From: Novel Incretin-Based Agents and Practical Regimens to Meet Needs and Treatment Goals of Patients With Type 2 Diabetes Mellitus
J Am Osteopath Assoc. 2011;111(7_suppl_5):S20-S30.
Figure Legend:
The American Association of Clinical Endocrinologists/American College of Endocrinology algorithm for treatment of patients with type 2 diabetes mellitus. Abbreviations: AGI, alpha-glucosidase inhibitor; DPP-4, dipeptidyl peptidase-4; FPG, fasting plasma glucose; GLP-1, glucagon-like peptide-1; HbA1c, glycosylated hemoglobin; MET, metformin; PPG, postprandial glucose; SU, sulfonylurea; TZD, thiazolidinedione. Adapted with permission from Rodbard HW, et al.4 aFor patients with diabetes mellitus and HbA1c <6.5%, pharmacologic treatment may be considered. bDPP-4 if PPG and FPG or GLP-1 if PPG. cTZD if metabolic syndrome and/or nonalcoholic fatty liver disease. dHbA1c if PPG. eIf HbA1c goal not achieved safely. fLow-dose secretagogue recommended. gGlinide if PPG or SU if FPG. hDecrease secretagogue by 50% when added to GLP-1 or DPP-4. ia) Discontinue insulin secretagogue with multidose insulin; b) can use pramlintide with prandial insulin. jIf HbA1c >8.5%, combination pharmacologic treatment with agents that cause hypoglycemia should be used with caution. kGLP-1 not approved for initial combination pharmacologic treatment. lIf HbA1c >8.5%, in patients on dual therapy, insulin should be considered.
Date of download: 10/3/2017
Copyright © 2015 by the American Osteopathic Association.
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