Key Points
ÎÎGlycemic targets and glucose-lowering therapies must be
individualized.
ÎÎDiet, exercise, and education remain the foundation of any type 2
diabetes mellitus (T2DM) treatment program.
ÎÎUnless there are prevalent contraindications, metformin is the
optimal first-line drug.
ÎÎAfter metformin, there are limited data to guide treatment.
Combination therapy with an additional 1-2 oral or injectable agents
is reasonable, aiming to minimize side effects where possible.
ÎÎUltimately, many patients will require insulin therapy alone or in
combination with other agents to maintain glucose control.
ÎÎAll treatment decisions, where possible, should be made in
conjunction with the patient, focusing on his/her preferences, needs,
and values.
ÎÎComprehensive cardiovascular risk reduction must be a major focus
of therapy.
Figure 1. Age-Adjusted Percentage of U.S. Adults with
Obesity or Diagnosed Diabetes
