Statement by an American Association of Clinical Endocrinologists/ American College of Endocrinology Consensus Panel on Type 2 Diabetes Mellitus: An Algorithm for Glycemic Control

Rodbard, Helena W.; Jellinger, Paul S.; Davidson, Jaime A.; Einhorn, Daniel; Garber, Alan J.; Grunberger, George; Handelsman, Yehuda; Horton, Edward S.; Lebovitz, Harold E.; Levy, Philip; Moghissi, Etie S.; Schwartz, Stanley; Bloomgarden, Zachary T.

doi:10.4158/ep.15.6.540

Cited by 849 publications

(879 citation statements)

References 33 publications

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“…As metformin is considered the first-line drug therapy for the management of T2DM [10,11], it is of interest to compare the efficacy (and safety) of aDPP-4 inhibitor with that of metformin in drug-naive T2DM patients insufficiently controlled with diet and exercise [12][13][14][15][16][17][18][19][20][21]. Overall, metformin (1000-2000 mg/day) demonstrated slightly (but significantly) greater reductions in both HbA 1c and body weight ( Table 1, Fig.…”

Section: Gliptins As Monotherapymentioning

confidence: 99%

DPP-4 inhibitors in the management of type 2 diabetes: A critical review of head-to-head trials

Scheen¹

2012

Diabetes & Metabolism

170

121

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Dipeptidyl peptidase-4 (DPP-4) inhibitors offer new options for the management of type 2 diabetes. Direct comparisons with active glucose-lowering comparators in drug-naive patients have demonstrated that DPP-4 inhibitors exert slightly less pronounced HbA 1c reduction than metformin (with the advantage of better gastrointestinal tolerability) and similar glucose-lowering effects as with a thiazolidinedione (TZD; with the advantage of no weight gain). In metformin-treated patients, gliptins were associated with similar HbA 1c reductions compared with a sulphonylurea (SU; with the advantage of no weight gain, considerably fewer hypoglycaemic episodes and no need for titration) and a TZD (with the advantage of no weight gain and better overall tolerability). DPP-4 inhibitors also exert clinically relevant glucose-lowering effects compared with a placebo in patients treated with SU or TZD (of potential interest when metformin is either not tolerated or contraindicated), and as oral triple therapy with a good tolerability profile when added to a metformin-SU or pioglitazone-SU combination. Several clinical trials also showed a consistent reduction in HbA 1c when DPP-4 inhibitors were added to basal insulin therapy, with no increased risk of hypoglycaemia. Because of the complex pathophysiology of type 2 diabetes and the complementary actions of glucose-lowering agents, initial combination of a DPP-4 inhibitor with either metformin or a glitazone may be applied in drug-naive patients, resulting in greater efficacy and similar safety compared with either drug as monotherapy. However, DPP-4 inhibitors were less effective than GLP-1 receptor agonists for reducing HbA 1c and body weight, but offer the advantage of being easier to use (oral instead of injected administration) and lower in cost. Only one head-tohead trial demonstrated the non-inferiority of saxagliptin vs sitagliptin. Clearly, more trials of direct comparisons between different incretin-based therapies are needed. Because of their pharmacokinetic characteristics, pharmacodynamic properties (glucose-dependent glucose-lowering effect) and good overall tolerability profile, DPP-4 inhibitors may have a key role to play in patients with renal impairment and in the elderly. The role of DPP-4 inhibitors in the therapeutic armamentarium of type 2 diabetes is rapidly evolving as their potential strengths and weaknesses become better defined mainly through controlled clinical trials. Keywords:Clinical trial-DPP-4 inhibitor; Alogliptin; Linagliptin; Saxagliptin; Sitagliptin; Vildagliptin; Type 2 diabetes mellitus; Review Résumé Les inhibiteurs de la DPP-4 dans le traitement du diabète de type 2 : revue critique des essais cliniques contrôlés.Les inhibiteurs de la dipeptidylpeptidase-4 (DPP-4) offrent de nouvelles options pour le traitement du diabète de type 2. Des comparaisons directes avec d'autres médicaments antidiabétiques chez des patients naïfs de tout traitement ont démontré que les inhibiteurs de la DPP-4 étaient un peu moins puissants pour diminuer ...

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Section: Gliptins As Monotherapymentioning

confidence: 99%

DPP-4 inhibitors in the management of type 2 diabetes: A critical review of head-to-head trials

Scheen¹

2012

Diabetes & Metabolism

170

121

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“…This progressive nature of the disease is known to cause the gradual loss of efficacy in existing therapies [2]. Side effects associated with existing therapies include hypoglycaemia, weight gain, oedema and gastrointestinal problems [3,4]. As such, there is a need for new medications for the treatment of type 2 diabetes, especially those with novel mechanisms of action, that can be used alone or in combination therapy to help patients achieve and maintain glycaemic targets, without the limiting side effects of current therapies [4].…”

Section: Introductionmentioning

confidence: 99%

Pharmacokinetics of Empagliflozin, a Sodium Glucose Cotransporter 2 Inhibitor, and Glimepiride Following Co-administration in Healthy Volunteers: A Randomised, Open-label, Crossover Study

Macha¹,

Mattheus²,

Pinnetti³

et al. 2012

J Diab Res Clin Met

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“…The AACE/ACE review of the risks and benefits of various classes of medications (see Table 1 in [4]) and considerations for selection of therapy is remarkably similar to that of Schernthaner et al [1]. However, the AACE/ACE algorithm, available at www.aace.com/pub (accessed 28 August 2010), provides a flowchart or 'treatment path' (see Fig.…”

mentioning

confidence: 99%

“…However, the AACE/ACE algorithm, available at www.aace.com/pub (accessed 28 August 2010), provides a flowchart or 'treatment path' (see Fig. 1 in [4]) that is simple, clear, and provides meaningful priorities and guidance to the user [4]. It also provides more specific guidance than some alternatives [3,5,6].…”

mentioning

confidence: 99%

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The American Association of Clinical Endocrinologists/American College of Endocrinology (AACE/ACE) algorithm for managing glycaemia in patients with type 2 diabetes mellitus: comparison with the ADA/EASD algorithm

Rodbard¹,

Jellinger

2010

Diabetologia

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Statement by an American Association of Clinical Endocrinologists/ American College of Endocrinology Consensus Panel on Type 2 Diabetes Mellitus: An Algorithm for Glycemic Control

Cited by 849 publications

References 33 publications

DPP-4 inhibitors in the management of type 2 diabetes: A critical review of head-to-head trials

DPP-4 inhibitors in the management of type 2 diabetes: A critical review of head-to-head trials

Pharmacokinetics of Empagliflozin, a Sodium Glucose Cotransporter 2 Inhibitor, and Glimepiride Following Co-administration in Healthy Volunteers: A Randomised, Open-label, Crossover Study

The American Association of Clinical Endocrinologists/American College of Endocrinology (AACE/ACE) algorithm for managing glycaemia in patients with type 2 diabetes mellitus: comparison with the ADA/EASD algorithm

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