From the Guidelines
The most effective approach for managing type 2 diabetes involves a comprehensive strategy combining lifestyle modifications and medication, with a focus on person-centered care and consideration of individual factors such as comorbidities and treatment goals. This approach is supported by the most recent and highest quality study, which emphasizes the importance of a shared decision-making approach and consideration of the effects of medications on cardiovascular, kidney, weight, and other relevant comorbidities 1.
Key Components of Type 2 Diabetes Management
- Lifestyle modifications, including a balanced diet low in refined carbohydrates and high in vegetables, lean proteins, and healthy fats, along with regular physical activity (aim for at least 150 minutes of moderate exercise weekly) 1
- Weight loss of 5-10% of body weight is beneficial for overweight patients 1
- Medication, with metformin typically being the first-line drug due to its effectiveness, safety profile, and low hypoglycemia risk 1
- Consideration of additional medications, such as SGLT-2 inhibitors, GLP-1 receptor agonists, DPP-4 inhibitors, or sulfonylureas, based on individual factors 1
- Regular blood glucose monitoring, with a target HbA1c of less than 7% for most patients
Importance of Person-Centered Care
- A person-centered shared decision-making approach should guide the choice of glucose-lowering medications for adults with type 2 diabetes 1
- Consideration of individual factors, such as comorbidities, treatment goals, and preferences, is crucial in developing an effective treatment plan 1
Recent Updates and Recommendations
- The most recent study recommends using medications that provide sufficient effectiveness to achieve and maintain intended treatment goals, with consideration of the effects on cardiovascular, kidney, weight, and other relevant comorbidities; hypoglycemia risk; cost and access; risk for adverse reactions and tolerability; and individual preferences 1
- Early combination therapy can be considered in adults with type 2 diabetes at treatment initiation to shorten time to attainment of individualized treatment goals 1
From the FDA Drug Label
The main goal of treating diabetes is to lower your blood sugar to a normal level. High blood sugar can be lowered by diet and exercise, and by certain medicines when necessary. ACTOS is indicated as an adjunct to diet and exercise to improve glycemic control in adults with type 2 diabetes mellitus.
The recommended approach for managing type 2 diabetes includes:
- Diet and exercise to lower blood sugar levels
- Medicines, such as metformin and pioglitazone, when necessary to improve glycemic control 2 3 It is essential to talk to your healthcare provider about how to prevent, recognize, and take care of low blood sugar (hypoglycemia), high blood sugar (hyperglycemia), and problems related to diabetes.
From the Research
Type 2 Diabetes Management Approach
The recommended approach for managing type 2 diabetes involves a combination of lifestyle modifications and pharmacotherapy.
- Lifestyle modifications include dietary changes, increased physical activity, and weight loss, which have been shown to improve glucose homeostasis and reduce the risk of developing type 2 diabetes 4.
- Pharmacotherapy, such as metformin, sulphonylureas, insulin, and other agents, may be necessary to achieve and maintain glycemic control, especially in patients with comorbid conditions or risk factors for cardiovascular complications 5, 6.
Lifestyle Interventions
Lifestyle interventions, such as dietary modification and exercise training, have been shown to improve glucose homeostasis and reduce the risk of developing type 2 diabetes.
- A systematic review and meta-analysis found that lifestyle interventions can reduce the risk of type 2 diabetes by 47% 4.
- The Mediterranean dietary pattern has been recommended for the long-term prevention of diabetes 4.
- Increased physical activity and weight loss are also important components of lifestyle interventions for type 2 diabetes management 7, 8.
Pharmacological Interventions
Pharmacological interventions, such as metformin, insulin, and other agents, may be necessary to achieve and maintain glycemic control.
- Metformin is the cornerstone of initial management of type 2 diabetes mellitus, and other agents, such as sulphonylureas, insulin, and glucagon-like peptide-1 agonists, may be added as second or third-line therapy 6.
- Insulin therapy may be necessary for patients with advanced type 2 diabetes, and a stepwise approach, starting with basal insulin therapy and adding prandial insulin if necessary, is simple and effective 5.