Oral Hypoglycemic agent Treatment of T2DM

Oral Hypoglycemic agent
Treatment of T2DM

A.Amouzegar, MD

Endocrine Research Center,

Research Institute for Endocrine sciences

12.2.98

Drug choice

• Patient- centered approach
• Cost
• Level of HbA1C
• HbA1C goal
• Weight
• Hypoglycemia
• Established ASCVD or CKD or HF

Pharmacological therapy

• Metformin is the preferred initial pharmacologic agent for the treatment of T2DM.
• Once initiated, metformin should be continued as long as it is tolerated and not contraindicated; other agents, including insulin, should be added to metformin.
• Consider initiating dual therapy in patients with newly diagnosed T2DM who have A1C >1.5%  above their glycemic target.
• Intensification of treatment for pts with T2DM not meeting treatment goals should not be delayed.