Clinical Approach to Medical Management of Type 2 Diabetes

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Metformin Versus Active Comparators Study Characteristics N=289, 33 weeks, baseline A1c 8.2-8.4% N=486, 16 weeks, baseline A1c 8.5-8.8% N=1199, 52 weeks, baseline A1c 8.7% N=1091, 24 weeks, baseline A1c 8.6-8.8% N=820, 26 weeks baseline A1c 8.4-8.6% Metformin or Placebo A1c Effect Metformin vs. Placebo -1.4% +0.4% vs. Glyburide vs. Glyburide/Metformin -1.5% -1.9% -2.3% vs. Pioglitazone -1.5% -1.4% vs. Sitagliptin vs. Sitagliptin/Metformin vs. Exenatide LAR vs. Sitagliptin vs. Pioglitazone -1.13% (max dose) A1c Effect Comparator -0.66% -1.90% -1.5% ExeLAR -1.5% Sita -1.2% Pio -1.6% 1. Defronzo et al, NEJM, 1995 2.Garber et al, JCEM, 2003 3. Schernanter et al, JCEM, 2004 4.Goldstein et al, Diabetes Care, 2007. 5.Russel-Jones et al, Diabetes Care, 2012
Secretagogues: Sulfonylureas and the Meglitinides Mechanism: Depend upon: Increase basal and postprandial insulin secretion Functioning -cells, bind to different receptors Power: Decrease HbA 1c ~1.5% Dosing: Side effects: Main risk: Once to three times daily Weight gain Hypoglycemia, especially if CKD
Page 1 and 2: Clinical Approach to Medical Manage
Page 3 and 4: Outline: 1. Glycemic Targets in Typ
Page 5 and 6: Glycemic Goals of Therapy in Outpat
Page 7 and 8: Adjusted Hazard Ratio for Clinical
Page 9 and 10: Benefit assessment of long-term blo
Page 11 and 12: Outline: 1. Glycemic Targets in Typ
Page 13 and 14: Type 2 DM Treatment - Practical Tip
Page 15 and 16: The Biguanides: Basic Characteristi
Page 17 and 18: 10-Year Follow-up of Intensive cont
Page 19: Metformin: Old Drug, New Targets Li
Page 23 and 24: Secretagogues: Sulfonylureas and th
Page 25 and 26: Sulfonylurea Versus Newer Agents: G
Page 27 and 28: Basic Characteristics of Glitazones
Page 29 and 30: Pioglitazone • Is not associated
Page 31 and 32: The α-Glucosidase Inhibitors: Basi
Page 33 and 34: Types of Insulins • Basal insulin
Page 35 and 36: Prandial Versus Basal Insulin: The
Page 37 and 38: Insulin Initiation and Titration
Page 39 and 40: Colesevelam vs. Placebo in combinat
Page 41 and 42: Cycloset Safety Trial HR Bromocript
Page 43 and 44: • N=656 • DM2 for ~12 yrs • B
Page 45 and 46: So, we have 11 different classes of
Page 47 and 48: Comparative Effectiveness and Safet
Page 49 and 50: Pooled between-group differences in
Page 51 and 52: Effect of Antihyperglycemic Agents
Page 53 and 54: Yearly Cost for Different Antihyper
Page 55 and 56: 2012 Position Statement of the ADA
Page 57: Thank You !

Clinical Approach to Medical Management of Type 2 Diabetes

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