Abstract :
[en] The strategy for the management of type 2 diabetes, summarized by a group of experts of the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD), has been updated early 2015. As in the previous position statement published in 2012, a patientcentered approach is recommended and the choice of the best medication, after failure of metformin monotherapy, should be based on the efficacy and safety profile of each pharmacological class. Besides sulfonylureas, thiazolidinediones (pioglitazone), DPP-4 inhibitors, glucagon-like peptide-1 (GLP-1) receptor agonists or basal insulin, another new possibility consists in the addition of an inhibitor of sodium-glucose cotransporters type 2 (gliflozin). Thus, the variety of possible triple therapies is increasing dramatically. Furthermore, when a basal insulin (with or without metformin) is not able to adequately control blood glucose, instead of intensifying insulin therapy (as recommended in 2012), new opportunities are available with the addition of a gliptin, a gliflozin or a GLP-1 receptor agonist in the updated 2015 version. A global integrated approach targeting all risk factors is recommended to reduce cardiovascular complications, with a special emphasis on life-style.
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