Analgorithmis "a precise rule (or set of rules) specifying how to solve some problem".
The American Association of Clinical Endocrinologists (AACE) and the American College of Endocrinology (ACE) have released new treatment algorithms for Type 2 diabetes.
"We believe that this algorithm represents the treatment preferences of most clinical endocrinologists, but in the absence of meaningful comparative data, it is not necessarily an official AACE position," they noted.
Lifestyle changes (diet and exercise) are still stressed. Three separate, and perhaps "over-simplified", pathways are proposed:
(1) Monotherapy (one drug) for patients with HbA1c levels under 7.5%
(2) Two drugs for HbA1c values between 7.65 and 9.0%
(3) Three drugs for HbA1c levels greater than 9.0%
Patients with sub-optimal control with "triple therapy" should get a basal insulin. Specifically, the use of "NPH" insulin is now downplayed.
Whatever treatment regimen is begun, they said, its effectiveness should be monitored every two to three months by measuring hemoglobin A1c. Therapy should be regularly intensified, if necessary, to reach the target.
Newer drugs are more highly recommended as a result of better safety profiles, primarily less hypoglycemia (low blood sugar).Because of this stratification, they said, "we have given sulfonylureas much less priority because use of these agents is associated with hypoglycemia, weight gain, and limited duration of effectiveness after initiation of therapy."
On the other hand, the algorithm "favors the use of glucagonlike peptide-1 (GLP-1) agonists and dipeptidyl-peptidase-4 (DPP-4) inhibitors with higher priority because of their effectiveness and overall safety profiles," the authors
said.
Gee, the insurance providers aren't going to like that.We would add that drugs should be added one at a time. In that way, you can better gauge the individual impact of each drug and sort out any drug-related adverse events.The full article ishere.
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The American Association of Clinical Endocrinologists (AACE) and the American College of Endocrinology (ACE) have released new treatment algorithms for Type 2 diabetes.
Lifestyle changes (diet and exercise) are still stressed. Three separate, and perhaps "over-simplified", pathways are proposed:
(1) Monotherapy (one drug) for patients with HbA1c levels under 7.5%
(2) Two drugs for HbA1c values between 7.65 and 9.0%
(3) Three drugs for HbA1c levels greater than 9.0%
Patients with sub-optimal control with "triple therapy" should get a basal insulin. Specifically, the use of "NPH" insulin is now downplayed.
Newer drugs are more highly recommended as a result of better safety profiles, primarily less hypoglycemia (low blood sugar).
Gee, the insurance providers aren't going to like that.
We would add that drugs should be added one at a time. In that way, you can better gauge the individual impact of each drug and sort out any drug-related adverse events.
The full article ishere.