Emphasis on diet, exercise, and education; glycemic targets, therapies should be individualized
FRIDAY, April 20 (HealthDay News) -- Treatment of type 2 diabetes should be personalized in a patient-centered approach, with diet, exercise, and education forming the basis of any treatment program, supplemented by medications as necessary, according to a joint position statement issued by the American Diabetes Association and the European Association for the Study of Diabetes, published online April 19 in Diabetes Care.
Silvio E. Inzucchi, M.D., from the Yale University School of Medicine in Haven Hospital, Conn., and colleagues reviewed the literature and examined the evidence to develop recommendations for antihyperglycemic therapy in nonpregnant adults with type 2 diabetes.
The authors recommend that glycemic targets and glucose-lowering therapies should be individualized for each patient. Diet, exercise, and education are still the basis of any treatment program for type 2 diabetes, and resources should be made available. Metformin should be the first-line therapy for hyperglycemia, unless there are prevalent contraindications. Data are limited for subsequent therapies; combination of an additional one to two oral or injectable agents is reasonable, with emphasis on minimizing side effects. Ultimately, a substantial proportion of patients will require insulin treatment, either alone or in combination with other agents. Where possible, treatment decisions should be made in conjunction with the patients, focusing on specific needs, preferences, and values. A major focus of therapy should be reduction of cardiovascular risk.
"These recommendations should be considered within the context of the needs, preferences, and tolerances of each patient; individualization of treatment is the cornerstone of success," the authors write.
Several authors disclosed financial ties to the pharmaceutical industry.