Is the ADA/EASD algorithm for the management of type 2 diabetes (January 2009) based on evidence or opinion? A critical analysis

G. Schernthaner, A. H. Barnett, D. J. Betteridge, R. Carmena, A. Ceriello, B. Charbonnel, M. Hanefeld, R. Lehmann, M. T. Malecki, R. Nesto, V. Pirags, A. Scheen, J. Seufert, A. Sjohölm, A. Tsatsoulis, R. DeFronzo

Research output: Contribution to journalReview article

94 Scopus citations

Abstract

The ADA and the EASD recently published a consensus statement for the medical management of hyperglycaemia in patients with type 2 diabetes. The authors advocate initial treatment with metformin monotherapy and lifestyle modification, followed by addition of basal insulin or a sulfonylurea if glycaemic goals are not met (tier 1 recommendations). All other glucose-lowering therapies are relegated to a secondary (tier 2) status and only recommended for selected clinical settings. In our view, this algorithm does not offer physicians and patients the appropriate selection of options to individualise and optimise care with a view to sustained control of blood glucose and reduction both of diabetes complications and cardiovascular risk. This paper critically assesses the basis of the ADA/EASD algorithm and the resulting tiers of treatment options.

Original languageEnglish (US)
Pages (from-to)1258-1269
Number of pages12
JournalDiabetologia
Volume53
Issue number7
DOIs
StatePublished - Jul 2010

Keywords

  • ADA consensus statement
  • Algorithm
  • Cardiovascular risk
  • EASD consensus statement
  • Glucose-lowering therapy
  • Hyperglycaemia
  • Type 2 diabetes

ASJC Scopus subject areas

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism

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    Schernthaner, G., Barnett, A. H., Betteridge, D. J., Carmena, R., Ceriello, A., Charbonnel, B., Hanefeld, M., Lehmann, R., Malecki, M. T., Nesto, R., Pirags, V., Scheen, A., Seufert, J., Sjohölm, A., Tsatsoulis, A., & DeFronzo, R. (2010). Is the ADA/EASD algorithm for the management of type 2 diabetes (January 2009) based on evidence or opinion? A critical analysis. Diabetologia, 53(7), 1258-1269. https://doi.org/10.1007/s00125-010-1702-3