J Korean Diabetes.  2018 Jun;19(2):71-75. 10.4093/jkd.2018.19.2.71.

Paradigm Changes in Diabetes Management Guidelines: American Diabetes Association 2018

• Park JH

• KMID: 2415849
• DOI: http://doi.org/10.4093/jkd.2018.19.2.71

Abstract

The management of type 2 diabetes mellitus should comprise healthy lifestyle modifications along with tailored pharmacologic treatment. Traditionally, the American Diabetes Association (ADA)'s Diabetes Management Guidelines have not prioritized specific anti-diabetic drugs over others with regard to cardiovascular disease (CVD) and mortality prevention. Recently, two novel anti-diabetic medications proved to be significantly protective against future CVD and mortality, regardless of the glycemic levels achieved in type 2 diabetic patients with pre-existing CVD. The 2018 ADA Guidelines recommend SGLT2 inhibitor and/or GLP-1 receptor agonist be used for type 2 diabetes patients with atherosclerotic CVD after metformin monotherapy failure. Considering the value of CVD protection in the management of diabetes mellitus, this minor guideline adjustment could have far-reaching implications.

Keyword

Agonist; Cardiovascular diseases; Diabetes mellitus; Glucagon-like peptide-1 receptor; Inhibitor; Mortality; Sodium-glucose transporter 2

MeSH Terms

Cardiovascular Diseases
Diabetes Mellitus
Diabetes Mellitus, Type 2
Glucagon-Like Peptide-1 Receptor
Humans
Life Style
Metformin
Mortality
Sodium-Glucose Transporter 2
Glucagon-Like Peptide-1 Receptor
Metformin
Sodium-Glucose Transporter 2

Figure

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  Fig. 1 The American Diabetes Association 2018 antihyperglycemic therapy in type 2 diabetes: general recommendations. Adapted from the article of American Diabetes Association (Diabetes Care 2018;41:S73–85) [1] with original copyright holder's permission. A1C, HbA1c; ASCVD, atherosclerotic cardiovascular disease.

Reference

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