Medical management of hyperglycaemia in type 2 diabetes mellitus: a consensus algorithm for the initiation and adjustment of therapy: A consensus statement from the American Diabetes Association and the European Association for the Study of Diabetes
Open accessAbstract
The consensus algorithm for the medical management of type 2 diabetes was published in August 2006 with the expectation that it would be updated, based on the availability of new interventions and new evidence to establish their clinical role. The authors continue to endorse the principles used to develop the algorithm and its major features. We are sensitive to the risks of changing the algorithm cavalierly or too frequently, without compelling new information. An update to the consensus algorithm published in January 2008 specifically addressed safety issues surrounding the thiazolidinediones. In this revision, we focus on the new classes of medications that now have more clinical data and experience.
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Metformin reduces fasting glucose mainly through its effect on hepatic glucose output.
“Metformin reduces fasting glucose mainly through its effect on hepatic glucose output.95”
From Prediabetes: a high-risk state for diabetes development (2012) · cites this paper as [95]
Glitazones such as troglitazone, rosiglitazone, and pioglitazone act through the PPAR-γ receptor by increasing hepatic and peripheral insulin sensitivity and preserving insulin secretion.
“The glitazones, such as troglitazone, rosiglitazone and pioglitazone, act through the PPAR-γ receptor by increasing hepatic and peripheral insulin sensitivity and preserving insulin secretion.45,95”
From Prediabetes: a high-risk state for diabetes development (2012) · cites this paper as [95]
α-glucosidase inhibitors reduce the rate of polysaccharide digestion from the proximal small intestine and primarily lower postprandial glucose without causing hypoglycaemia.
“α-glucosidase inhibitors reduce the rate of polysaccharide digestion from the proximal small intestine. They primarily lower postprandial glucose without causing hypoglycaemia.”
From Prediabetes: a high-risk state for diabetes development (2012) · cites this paper as [95]
Because their effect on A1c is smaller than that of other oral antidiabetic agents, α-glucosidase inhibitors are seldom used in the treatment of type 2 diabetes.
“Since their effect on A1c is smaller than that of other oral antidiabetic agents, they are seldom used in the treatment of type 2 diabetes.95”
From Prediabetes: a high-risk state for diabetes development (2012) · cites this paper as [95]
Troglitazone was withdrawn from the European market for probable serious hepatotoxicity, and rosiglitazone for possible increases in cardiovascular risk.
“Two thiazolidinedione drugs were withdrawn from the European market, troglitazone for probable serious hepatotoxicity, and rosiglitazone due to possible increases in cardiovascular risk.45,95”
From Prediabetes: a high-risk state for diabetes development (2012) · cites this paper as [95]
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References 118 · Cited by 712
- Authors
- Nathan, D. M., Buse, J. B., Davidson, M. B., Ferrannini, E., Holman, R. R., Sherwin, R., & Zinman, B.
- Affiliations
- Harvard University (US)
- University of North Carolina at Chapel Hill (US)
- Charles R. Drew University of Medicine and Science (US)
- University of Pisa (IT)
- University of Oxford (GB)
- Yale University (US)
- Mount Sinai Hospital (CA)
- Corresponding author
- Nathan, D. M.
- Venue
- Diabetologia
- Published
- 2008-10-22
- Volume
- 52
- Issue
- 1
- Pages
- 17-30
- ISSN
- 0012-186X (ISSN-L)
- 1432-0428
- OpenAlex
- W2139562487
- Cited by
- 712
- References
- 118
- Citations by year
- 2026: 4 · 2025: 7 · 2024: 6 · 2023: 10 · 2022: 18 · 2021: 13 · 2020: 16 · 2019: 18 · 2018: 20 · 2017: 30 · 2016: 34 · 2015: 33 · 2014: 47 · 2013: 79 · 2012: 115
- FWCI
- 62.65
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- www.springer.com/tdm (tdm)
- Locations
- Diabetologia (publishedVersion)
- PubMed (publishedVersion)
- CINECA IRIS Institutial research information system (University of Pisa) (submittedVersion)
- Funders
- Bristol-Myers Squibb
- Eli Lilly and Company
- Pfizer
- AstraZeneca
- GlaxoSmithKline
- Sanofi
- Insulet Corporation
- MannKind Corporation
- Novo Nordisk
- Servier
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Keywords
- type 2 diabetes, hyperglycemia, medical management, consensus algorithms, thiazolidinediones, drug safety
- MeSH terms
- Algorithms, Diabetes Mellitus, Type 2, Europe, Hyperglycemia, Hypoglycemic Agents, Life Style, Societies, Medical, United States, Controlled Clinical Trials as Topic
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