Medical Management of Hyperglycemia in Type 2 Diabetes: A Consensus Algorithm for the Initiation and Adjustment of Therapy: A consensus statement of the American Diabetes Association and the European Association for the Study of Diabetes

David M. Nathan; John B. Buse; Mayer B. Davidson; Ele Ferrannini; Rury R. Holman; Robert Sherwin; Bernard Zinman

doi:10.2337/dc08-9025

Reviews/Commentaries/ADA Statements

Medical Management of Hyperglycemia in Type 2 Diabetes: A Consensus Algorithm for the Initiation and Adjustment of Therapy

A consensus statement of the American Diabetes Association and the European Association for the Study of Diabetes

David M. Nathan, MD1,
John B. Buse, MD, PHD2,
Mayer B. Davidson, MD3,
Ele Ferrannini, MD4,
Rury R. Holman, FRCP5,
Robert Sherwin, MD6 and
Bernard Zinman, MD7

¹Diabetes Center, Massachusetts General Hospital, Boston, Massachusetts
²University of North Carolina School of Medicine, Chapel Hill, North Carolina
³Clinical Center for Research Excellence, Charles R. Drew University, Los Angeles, California
⁴Department of Internal Medicine, University of Pisa, Pisa, Italy
⁵Diabetes Trials Unit, Oxford Centre for Diabetes, Endocrinology and Metabolism, Oxford University, Oxford, U.K.
⁶Department of Internal Medicine and Yale Center for Clinical Investigation, Yale University School of Medicine, New Haven, Connecticut
⁷Samuel Lunenfeld Research Institute, Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada

Corresponding author: David. M. Nathan, dnathan{at}partners.org

Diabetes Care 2009 Jan; 32(1): 193-203. https://doi.org/10.2337/dc08-9025

A consensus statement of the American Diabetes Association and the European Association for the Study of Diabetes

Abstract

The consensus algorithm for the medical management of type 2 diabetes was published in August 2006 with the expectation that it would be updated, based on the availability of new interventions and new evidence to establish their clinical role. The authors continue to endorse the principles used to develop the algorithm and its major features. We are sensitive to the risks of changing the algorithm cavalierly or too frequently, without compelling new information. An update to the consensus algorithm published in January 2008 specifically addressed safety issues surrounding the thiazolidinediones. In this revision, we focus on the new classes of medications that now have more clinical data and experience.

Footnotes

This article is being simultaneously published in 2009 by Diabetes Care and Diabetologia by the American Diabetes Association and the European Association for the Study of Diabetes.

An American Diabetes Association consensus statement represents the authors’ collective analysis, evaluation, and opinion at the time of publication and does not represent official association opinion.
DIABETES CARE

View Full Text