Key Points
ÎGlycemic targets and glucose-lowering therapies must be individualized.
ÎDiet, exercise, and education remain the foundation of any type 2 diabetes mellitus (T2DM) treatment program.
ÎUnless there are prevalent contraindications, metformin is the optimal first-line drug.
ÎAfter 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.
ÎUltimately, many patients will require insulin therapy alone or in combination with other agents to maintain glucose control.
ÎAll treatment decisions, where possible, should be made in conjunction with the patient, focusing on his/her preferences, needs, and values.
ÎComprehensive cardiovascular risk reduction must be a major focus of therapy.
Figure 1. Age-Adjusted Percentage of U.S. Adults with Obesity or Diagnosed Diabetes
