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An Overview of Type 2 Diabetes

Scott R. Drab, PharmD, CDE, BC-ADM
Suggested Readings

New forms of insulin and insulin therapies for the treatment of type 2 diabetes.

Cahn A, Miccoli R, Dardano A, Del Prato S. Lancet Diabetes Endocrinol. 2015;3(8):638-652.

From the triumvirate to the ominous octet: a new paradigm for the treatment of type 2 diabetes mellitus.

Defronzo RA. Diabetes. 2009;58(4):773-795.

Glucagon-like peptide-1 receptor agonist and basal insulin combination treatment for the management of type 2 diabetes: a systematic review and meta-analysis.

Eng C, Kramer CK, Zinman B, Retnakaran R. Lancet. 2014;384(9961):2228-2234.

Minimizing hypoglycemia in diabetes.

International Hypoglycemia Study Group. Diabetes Care. 2015;38(8):1583-1591.

Management of hyperglycemia in type 2 diabetes, 2015: a patient-centered approach: update to a position statement of the American Diabetes Association and the European Association for the Study of Diabetes.

Inzucchi SE, Bergenstal RM, Buse JB, et al. Diabetes Care. 2015;38(1):140-149.

Minimizing hypoglycemia and weight gain with intensive glucose control: potential benefits of a new combination therapy (IDegLira).

Morales J, Merker L. Adv Ther. 2015;32(5):391-403.

Basal insulin and cardiovascular and other outcomes in dysglycemia.

ORIGIN Trial Investigators. N Engl J Med. 2012;367(4):319-328.

Hypoglycaemia risk with insulin degludec compared with insulin glargine in type 2 and type 1 diabetes: a pre-planned meta-analysis of phase 3 trials

Ratner RE, Gough SC, Mathieu C, et al. Diabetes Obes Metab. 2013;15(2):175-184.

Patient-level meta-analysis of the EDITION 1, 2 and 3 studies: glycaemic control and hypoglycaemia with new insulin glargine 300 U/ml versus glargine 100 U/ml in people with type 2 diabetes

Ritzel R, Roussel R, Bolli GB, et al. Diabetes Obes Metab. 2015;17(9):859-867.

Benefits of combination of insulin degludec and liraglutide are independent of baseline glycated haemoglobin level and duration of type 2 diabetes.

Rodbard HW, et al. Diabetes Obes Metab. 2016;18(1):40-48

Linked Resources

Guidelines

Standards of medical care in diabetes—2015.

American Diabetes Association.  Diabetes Care. 2015;38(suppl 1):S1-S94. 

The ADA’s Standards of Care provide clinicians, patients, researchers, payers, and other interested individuals with the components of good diabetes management, general treatment goals, and tools to evaluate the quality of care. Importantly, these recommendations should be adjusted based on individual preferences, comorbidities, and other patient-related factors.

American Association of Clinical Endocrinologists and American College of Endocrinology—Clinical practice guidelines for developing a diabetes mellitus comprehensive care plan—2015.

Handelsman Y, Bloomgarden ZT, Grunberger G, et al. Endocr Pract. 2015;21(suppl 1):1-87.

These 2015 clinical practice guidelines provide a practical guide for comprehensive care that incorporates an integrated consideration of microvascular and macrovascular risk—including such cardiovascular risk factors as lipids, hypertension, and coagulation—rather than focusing only on glycemic control. The guidelines emphasize individualized targets for weight loss, glucose, lipid, and blood pressure, and contain updated information on hypertension management, nephropathy management, hypoglycemia, and antihyperglycemic therapy.

AACE/ACE comprehensive diabetes management algorithm 2015.

Garber AJ, Abrahamson MJ, Barzilay JI, et al. Endocr Pract. 2015;21(4):438-447.

This algorithm from the AACE addresses evaluating the whole patient, potential risks and complications, and evidence-based treatment approaches for diabetes. The document contains sections on obesity, prediabetes, hyperglycemia therapy (lifestyle modifications, pharmacotherapy, and insulin), hypertension management, hyperlipidemia treatment, and other risk-reduction strategies.

Patient Resource

Diabetes HealthSense

Provides easy access to resources to help patients live well and meet their goals—whether they have diabetes or are at risk for disease.

Decision Aids for T2DM

To facilitate shared decision making, these examples of medication choice decision aids from the Mayo Clinic are organized into 7 issues that may be of interest to patients with T2DM. A video demonstrating the use of these cards can be found at: https://www.youtube.com/watch?v=SYTPqceFgSw

Related activities
Webcast 
1.00 CME/CE

Clinical Updates in Type 2 Diabetes

New Strategies for Insulin Replacement Therapy

Faculty: Scott R. Drab, PharmD, CDE, BC-ADM; Stuart T. Haines, PharmD, BCPS, BCACP, BC-ADM; Joshua J. Neumiller, PharmD, CDE, FASCP
Release: 08/05/2016
Expiration: 08/05/2017