Update: ADA Standards of Medical Care in Diabetes Emphasize Metformin Therapy

Barring contraindication, patients with type 2 diabetes should undergo metformin therapy as first-line treatment.
Barring contraindication, patients with type 2 diabetes should undergo metformin therapy as first-line treatment.

HealthDay News — The American Diabetes Association (ADA) recommends metformin as first-line therapy for type 2 diabetes, according to a synopsis of the 2017 ADA Standards of Medical Care in Diabetes published online in the Annals of Internal Medicine.

James J. Chamberlain, MD, from St. Mark's Hospital and St. Mark's Diabetes Center in Salt Lake City, and colleagues reviewed the literature to add, clarify, and revise recommendations for the diagnosis and management of patients with diabetes based on new evidence and to update the ADA Standards of Medical Care.

The authors note that metformin is safe, effective, and inexpensive, and is associated with a reduced risk of cardiovascular events and death in patients with diabetes; metformin is recommended as the first-line treatment for type 2 diabetes and should be initiated at the time of diagnosis for most patients. Another treatment option should be considered for patients who do not tolerate or have contraindications to metformin. Initiation of dual combination therapy should be considered to more quickly achieve a target hemoglobin A1c (HbA1c) level for patients with a level of 9% or greater who are not acutely symptomatic. If the HbA1c target has not been achieved within about 3 months of therapy initiation, therapy should be intensified.

"This synopsis focuses on recommendations from the 2017 Standards about pharmacologic approaches to glycemic treatment of type 2 diabetes," the authors write.

Several authors disclosed financial ties to the pharmaceutical industry.

Reference

Chamberlin JJ, Herman WH, Leal S, et al. Pharmacologic therapy for type 2 diabetes: synopsis of the 2017 American Diabetes Association standards of medical care in diabetes [published online March 14, 2017]. Ann Intern Med. doi: 10.7326/M16-2937

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