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Published in: Current Diabetes Reports 11/2019

01-11-2019 | Sulfonylurea | Pharmacologic Treatment of Type 2 Diabetes (HE Lebovitz and G Bahtiyar, Section Editors)

Personalized Management of Type 2 Diabetes

Authors: Patricia R. Peter, Beatrice C. Lupsa

Published in: Current Diabetes Reports | Issue 11/2019

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Abstract

Purpose of Review

Our goal is to discuss how to personalize the management of patients with type 2 diabetes by adjusting glycemic targets and tailoring medical therapy to account for unique patient characteristics.

Recent Findings

We review the pharmacotherapeutic options for the management of type 2 diabetes, focusing on potential advantages and disadvantages of each class of agents. We also discuss how to approach specific patient subpopulations and propose a conceptual framework for incorporating these factors into clinical practice.

Summary

As the diabetes treatment landscape rapidly expands, physicians have the exciting opportunity to offer patients increasingly individualized care.
Literature
6.
go back to reference Effect of intensive blood-glucose control with metformin on complications in overweight patients with type 2 diabetes (UKPDS 34). UK Prospective Diabetes Study (UKPDS) Group. Lancet. 1998;352(9131):854–65.CrossRef Effect of intensive blood-glucose control with metformin on complications in overweight patients with type 2 diabetes (UKPDS 34). UK Prospective Diabetes Study (UKPDS) Group. Lancet. 1998;352(9131):854–65.CrossRef
7.
go back to reference Bain S, Druyts E, Balijepalli C, Baxter CA, Currie CJ, Das R, et al. Cardiovascular events and all-cause mortality associated with sulphonylureas compared with other antihyperglycaemic drugs: a Bayesian meta-analysis of survival data. Diabetes Obes Metab. 2017;19(3):329–35. https://doi.org/10.1111/dom.12821.CrossRefPubMed Bain S, Druyts E, Balijepalli C, Baxter CA, Currie CJ, Das R, et al. Cardiovascular events and all-cause mortality associated with sulphonylureas compared with other antihyperglycaemic drugs: a Bayesian meta-analysis of survival data. Diabetes Obes Metab. 2017;19(3):329–35. https://​doi.​org/​10.​1111/​dom.​12821.CrossRefPubMed
10.
go back to reference Dormandy JA, Charbonnel B, Eckland DJ, Erdmann E, Massi-Benedetti M, Moules IK, et al. Secondary prevention of macrovascular events in patients with type 2 diabetes in the PROactive Study (PROspective pioglitAzone Clinical Trial In macroVascular Events): a randomised controlled trial. Lancet. 2005;366(9493):1279–89. https://doi.org/10.1016/S0140-6736(05)67528-9.CrossRefPubMed Dormandy JA, Charbonnel B, Eckland DJ, Erdmann E, Massi-Benedetti M, Moules IK, et al. Secondary prevention of macrovascular events in patients with type 2 diabetes in the PROactive Study (PROspective pioglitAzone Clinical Trial In macroVascular Events): a randomised controlled trial. Lancet. 2005;366(9493):1279–89. https://​doi.​org/​10.​1016/​S0140-6736(05)67528-9.CrossRefPubMed
13.
15.
22.
go back to reference Grey A, Bolland M, Gamble G, Wattie D, Horne A, Davidson J, et al. The peroxisome proliferator-activated receptor-gamma agonist rosiglitazone decreases bone formation and bone mineral density in healthy postmenopausal women: a randomized, controlled trial. J Clin Endocrinol Metab. 2007;92(4):1305–10. https://doi.org/10.1210/jc.2006-2646.CrossRefPubMed Grey A, Bolland M, Gamble G, Wattie D, Horne A, Davidson J, et al. The peroxisome proliferator-activated receptor-gamma agonist rosiglitazone decreases bone formation and bone mineral density in healthy postmenopausal women: a randomized, controlled trial. J Clin Endocrinol Metab. 2007;92(4):1305–10. https://​doi.​org/​10.​1210/​jc.​2006-2646.CrossRefPubMed
35.
go back to reference •• Marso SP, Daniels GH, Brown-Frandsen K, Kristensen P, Mann JF, Nauck MA, et al. Liraglutide and cardiovascular outcomes in type 2 diabetes. N Engl J Med. 2016;375(4):311–22. https://doi.org/10.1056/NEJMoa1603827. The LEADER trial studied over 9000 T2DM patients at high CVD risk and showed that treatment with liraglutide led to a 13% reduction in the primary composite cardiac outcome and a 22% reduction in CV death when compared to placebo. CrossRefPubMedPubMedCentral •• Marso SP, Daniels GH, Brown-Frandsen K, Kristensen P, Mann JF, Nauck MA, et al. Liraglutide and cardiovascular outcomes in type 2 diabetes. N Engl J Med. 2016;375(4):311–22. https://​doi.​org/​10.​1056/​NEJMoa1603827. The LEADER trial studied over 9000 T2DM patients at high CVD risk and showed that treatment with liraglutide led to a 13% reduction in the primary composite cardiac outcome and a 22% reduction in CV death when compared to placebo. CrossRefPubMedPubMedCentral
36.
go back to reference •• Marso SP, Bain SC, Consoli A, Eliaschewitz FG, Jodar E, Leiter LA, et al. Semaglutide and Cardiovascular Outcomes in Patients with Type 2 Diabetes. N Engl J Med. 2016;375(19):1834–44. https://doi.org/10.1056/NEJMoa1607141. SUSTAIN-6 studied over 3000 T2DM patients at high CVD risk and found a 26% reduction in the primary composite cardiac outcome and a 12% reduction in progression of nephropathy in those treated with semaglutide versus placebo. CrossRefPubMed •• Marso SP, Bain SC, Consoli A, Eliaschewitz FG, Jodar E, Leiter LA, et al. Semaglutide and Cardiovascular Outcomes in Patients with Type 2 Diabetes. N Engl J Med. 2016;375(19):1834–44. https://​doi.​org/​10.​1056/​NEJMoa1607141. SUSTAIN-6 studied over 3000 T2DM patients at high CVD risk and found a 26% reduction in the primary composite cardiac outcome and a 12% reduction in progression of nephropathy in those treated with semaglutide versus placebo. CrossRefPubMed
43.
go back to reference Monami M, Nreu B, Scatena A, Cresci B, Andreozzi F, Sesti G, et al. Safety issues with glucagon-like peptide-1 receptor agonists (pancreatitis, pancreatic cancer and cholelithiasis): data from randomized controlled trials. Diabetes Obes Metab. 2017;19(9):1233–41. https://doi.org/10.1111/dom.12926.CrossRefPubMed Monami M, Nreu B, Scatena A, Cresci B, Andreozzi F, Sesti G, et al. Safety issues with glucagon-like peptide-1 receptor agonists (pancreatitis, pancreatic cancer and cholelithiasis): data from randomized controlled trials. Diabetes Obes Metab. 2017;19(9):1233–41. https://​doi.​org/​10.​1111/​dom.​12926.CrossRefPubMed
52.
go back to reference •• Neal B, Perkovic V, Mahaffey KW, de Zeeuw D, Fulcher G, Erondu N, et al. Canagliflozin and cardiovascular and renal events in type 2 diabetes. N Engl J Med. 2017;377(7):644–57. https://doi.org/10.1056/NEJMoa1611925. The CANVAS trial studied over 10,000 T2DM patients at risk for CVD who were treated with canagliflozin and found a 14% reduction in the primary composite cardiac outcome when compared to placebo. CrossRefPubMed •• Neal B, Perkovic V, Mahaffey KW, de Zeeuw D, Fulcher G, Erondu N, et al. Canagliflozin and cardiovascular and renal events in type 2 diabetes. N Engl J Med. 2017;377(7):644–57. https://​doi.​org/​10.​1056/​NEJMoa1611925. The CANVAS trial studied over 10,000 T2DM patients at risk for CVD who were treated with canagliflozin and found a 14% reduction in the primary composite cardiac outcome when compared to placebo. CrossRefPubMed
56.
go back to reference Shibuya T, Fushimi N, Kawai M, Yoshida Y, Hachiya H, Ito S, et al. Luseogliflozin improves liver fat deposition compared to metformin in type 2 diabetes patients with non-alcoholic fatty liver disease: a prospective randomized controlled pilot study. Diabetes Obes Metab. 2018;20(2):438–42. https://doi.org/10.1111/dom.13061.CrossRefPubMed Shibuya T, Fushimi N, Kawai M, Yoshida Y, Hachiya H, Ito S, et al. Luseogliflozin improves liver fat deposition compared to metformin in type 2 diabetes patients with non-alcoholic fatty liver disease: a prospective randomized controlled pilot study. Diabetes Obes Metab. 2018;20(2):438–42. https://​doi.​org/​10.​1111/​dom.​13061.CrossRefPubMed
57.
go back to reference Ito D, Shimizu S, Inoue K, Saito D, Yanagisawa M, Inukai K, et al. Comparison of ipragliflozin and pioglitazone effects on nonalcoholic fatty liver disease in patients with type 2 diabetes: a randomized, 24-week, open-label, active-controlled trial. Diabetes Care. 2017;40(10):1364–72. https://doi.org/10.2337/dc17-0518.CrossRefPubMed Ito D, Shimizu S, Inoue K, Saito D, Yanagisawa M, Inukai K, et al. Comparison of ipragliflozin and pioglitazone effects on nonalcoholic fatty liver disease in patients with type 2 diabetes: a randomized, 24-week, open-label, active-controlled trial. Diabetes Care. 2017;40(10):1364–72. https://​doi.​org/​10.​2337/​dc17-0518.CrossRefPubMed
71.
go back to reference Garber AJ, Abrahamson MJ, Barzilay JI, Blonde L, Bloomgarden ZT, Bush MA, et al. Consensus statement by the American Association of Clinical Endocrinologists and American College of Endocrinology on the comprehensive type 2 diabetes management algorithm - 2019 executive summary. Endocr Pract. 2019;25(1):69–100. https://doi.org/10.4158/CS-2018-0535.CrossRefPubMed Garber AJ, Abrahamson MJ, Barzilay JI, Blonde L, Bloomgarden ZT, Bush MA, et al. Consensus statement by the American Association of Clinical Endocrinologists and American College of Endocrinology on the comprehensive type 2 diabetes management algorithm - 2019 executive summary. Endocr Pract. 2019;25(1):69–100. https://​doi.​org/​10.​4158/​CS-2018-0535.CrossRefPubMed
Metadata
Title
Personalized Management of Type 2 Diabetes
Authors
Patricia R. Peter
Beatrice C. Lupsa
Publication date
01-11-2019
Publisher
Springer US
Published in
Current Diabetes Reports / Issue 11/2019
Print ISSN: 1534-4827
Electronic ISSN: 1539-0829
DOI
https://doi.org/10.1007/s11892-019-1244-0

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