Clinical Approach to Medical Management of Type 2 Diabetes

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Benefit assessment of long-term blood glucose lowering to near-normal levels in patients with type 2 diabetes mellitus • Systematic review of seven RCT including 28,000 patients with type 2 DM – ACCORD – ADVANCE – VADT – UKPDS – KUMAMOTO – UGDP – Van der Does • The primary outcome was all-cause mortality • Secondary outcomes were late complications (MI, stroke, ESRD, amputation, blindness, therapy-related factors in terms of severe hypoglycemia and serious adverse advents) Institute for Quality and Efficiency in Health Care Report No. A05-07, 2011
Benefit assessment of long-term blood glucose lowering to near-normal levels in patients with type 2 diabetes mellitus • A benefit or harm of intensive BG lowering was not proven for any of the patient-relevant investigated outcomes – mortality or diabetes-related complications (fatal or non-fatal MI, fatal or non-fatal stroke, ESRD, amputation, or blindness) • The data provide indications of harm through an increased rate of severe hypoglycemia and serious adverse events independent of hypoglycemia Institute for Quality and Efficiency in Health Care Report No. A05-07, 2011
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: Adjusted Hazard Ratio for Clinical
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 and 20: Metformin: Old Drug, New Targets Li
Page 21 and 22: Secretagogues: Sulfonylureas and th
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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