AACE/ACE Comprehensive Diabetes Management Algorithm 2015

Garber, Alan J.; Abrahamson, Martin J.; Barzilay, Joshua I.; Blonde, Lawrence; Bloomgarden, Zachary T.; Bush, Michael D.; Dagogo‐Jack, Samuel; Davidson, Michael; Einhorn, Daniel; Garber, Jeffrey R.; Garvey, W. Timothy; Grunberger, George; Handelsman, Yehuda; Hirsch, Irl B.; Jellinger, Paul S.; McGill, Janet B.; Mechanick, Jeffrey I.; Rosenblit, Paul D.; Umpiérrez, Guillermo E.; Davidson, Michael

doi:10.4158/ep15693.cs

Cited by 222 publications

(253 citation statements)

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“…For this reason, the American Diabetes Association, European Association for the Study of Diabetes, International Diabetes Federation, and others have established treatment goals in terms of HbA1c and other glycemic laboratory measures. Guidance developed by these governing bodies are similar, with HbA1c targets of either <7.0% or ≤6.5% [8][9][10].…”

Section: Introductionmentioning

confidence: 89%

Dulaglutide in the treatment of adult type 2 diabetes: a perspective for primary care providers

Anderson¹,

Thieu

Boye

et al. 2016

Postgraduate Medicine

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Approximately 90% of T2D patients in the US are diagnosed and treated in the primary care setting, and the majority of the burden of disease management falls to primary care providers. Here, we discuss the clinical data for once weekly dulaglutide, e.g. the results of seven completed Phase 3 trials, patient preference studies, patient reported outcomes (PRO), and clinical data surrounding the dulaglutide administration device. Dulaglutide 1.5 mg once weekly demonstrated superiority to placebo, metformin, sitagliptin, exenatide BID, and insulin glargine (in 2 trials), and non-inferiority to liraglutide in reduction of HbA1c from baseline, with an acceptable safety profile. Dulaglutide-treated patients achieved the composite endpoint of an HbA1c <7.0% with no hypoglycemia, no severe hypoglycemia, and no weight gain significantly more than metformin, sitagliptin, exenatide BID or insulin glargine treated patients. Dulaglutide consistently showed an early onset of glycemic control, lasting up to 104 weeks. Additionally, PRO and patient preference data support the benefit of once weekly dulaglutide for the treatment of T2D. ARTICLE HISTORY

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Section: Introductionmentioning

confidence: 89%

Dulaglutide in the treatment of adult type 2 diabetes: a perspective for primary care providers

Anderson¹,

Thieu

Boye

et al. 2016

Postgraduate Medicine

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“…Details about the effects of and rationale for available antihyperglycemic agents can be found in the 2015 AACE Comprehensive Diabetes Management Algorithm Consensus Statement (4). The AACE recommends initiating therapy with metformin, a glucagon-like peptide 1 (GLP-1) receptor agonist, a dipeptidyl peptidase 4 (DPP-4) inhibitor, a sodium glucose cotransporter 2 (SGLT2) inhibitor, or an α-glucosidase inhibitor for patients with an entry A1C <7.5% (Grade C; BEL 3) .…”

Section: Executive Summarymentioning

confidence: 99%

“…Intensification of pharmacotherapy requires glucose monitoring and medication adjustment at appropriate intervals (e.g., every 3 months) when treatment goals are not achieved or maintained ( Grade C; BEL 3 ). The 2015 AACE algorithm outlines treatment choices on the basis of the A1C level (4 [EL 4; NE]).…”

Section: Executive Summarymentioning

confidence: 99%

American Association of Clinical Endocrinologists and American College of Endocrinology – Clinical Practice Guidelines for Developing A Diabetes Mellitus Comprehensive Care Plan – 2015 — Executive Summary

et al. 2015

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“…The joint position statement of the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD) recommends initial combination therapy in patients with baseline HbA1c ≥ 9% and who are less likely to achieve treatment goals on monotherapy 1, 2. The American Association of Clinical Endocrinologists’ and American College of Endocrinology's (AACE/ACE) comprehensive diabetes management algorithm recommends initial dual therapy when HbA1c is ≥ 7.5%, and combination therapy with insulin (symptomatic hyperglycaemia) or without insulin (asymptomatic hyperglycaemia) when HbA1c is ≥ 9% 3. Initial combination therapy potentially offers advantages such as rapid reduction in HbA1c, avoidance of extended periods of hyperglycaemic state and harmful effects of glucotoxicity, and avoidance of maximal doses of monotherapy which may augment adverse effects associated with that monotherapy 4, 5.…”

Section: Introductionmentioning

confidence: 99%

“…However, aggressive treatment to achieve glycaemic control may not always be suitable depending on the patient and disease characteristics, and therefore, glycaemic targets must be individualised according to the needs of each patient. When the need for combination therapy has been established, drugs with complementary mechanisms of action should be employed for optimum glycaemic control 3.…”

Section: Introductionmentioning

confidence: 99%

Empagliflozin/linagliptin single‐tablet combination: first‐in‐class treatment option

Woo

2015

Int J Clin Pract

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SummaryBackgroundThe availability of a dual sodium glucose co‐transporter 2/dipeptidyl peptidase‐4 inhibitor combination in a single‐tablet combination (STC) represents a new therapeutic option for patients with type 2 diabetes. Empagliflozin/linagliptin STC has been recently approved by the US Food and Drug Administration for the treatment of type 2 diabetes mellitus (T2DM).AimThe aim of this study was to describe the latest clinical evidence on the efficacy and safety profiles of empagliflozin/linagliptin STCs in comparison with the individual components. Juxtaposition of the STC with dapagliflozin/saxagliptin combination was also presented.ResultsEmpagliflozin/linagliptin STC given as initial therapy or on metformin background lowered mean glycated haemoglobin (HbA1c) by approximately 1.1% (mean baseline HbA1c, 8.0%). Furthermore, the STC reduced mean body weight by 2.0–3.0 kg from baseline. With the STC treatment, no confirmed incidents of hypoglycaemia were reported in drug‐naïve patients; in patients taking metformin hypoglycaemia occurred at low rates which were comparable with monotherapy. Use of STCs in the treatment of T2DM can simplify drug dosing regimen, reduce pill burden and increase treatment adherence. Empagliflozin/linagliptin STC is a combination that offers potential additional benefits such as body weight loss and moderate reductions in blood pressure, without increasing risk of hypoglycaemia.ConclusionEmpagliflozin/linagliptin STC appears to be a rational choice for a wide range of patients in need of multiple agents for controlling hyperglycaemia. The STC should be particularly useful in patients in whom hypoglycaemia, weight gain and treatment adherence are of concern.

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AACE/ACE Comprehensive Diabetes Management Algorithm 2015

Cited by 222 publications

References 0 publications

Dulaglutide in the treatment of adult type 2 diabetes: a perspective for primary care providers

Dulaglutide in the treatment of adult type 2 diabetes: a perspective for primary care providers

American Association of Clinical Endocrinologists and American College of Endocrinology – Clinical Practice Guidelines for Developing A Diabetes Mellitus Comprehensive Care Plan – 2015 — Executive Summary

Empagliflozin/linagliptin single‐tablet combination: first‐in‐class treatment option

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