World Health Organization Guidelines on Medicines for Diabetes Treatment Intensification (2019)

Letters16 April 2019World Health Organization Guidelines on Medicines for Diabetes Treatment IntensificationChester B. Good, MD, MPH, Norman R. Kolb, MD, and Mark Meyer, MDChester B. Good, MD, MPHUniversity of Pittsburgh, Pittsburgh, Pennsylvania (C.B.G., N.R.K., M.M.), Norman R. Kolb, MDUniversity of Pittsburgh, Pittsburgh, Pennsylvania (C.B.G., N.R.K., M.M.), and Mark Meyer, MDUniversity of Pittsburgh, Pittsburgh, Pennsylvania (C.B.G., N.R.K., M.M.)Author, Article, and Disclosure Informationhttps://doi.org/10.7326/L19-0068 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:Humphrey and colleagues (1) suggest that choosing a second-line antidiabetic agent (after metformin) for patients in resource-poor settings outside the United States is difficult. We disagree. Discussions about risk for hypoglycemia associated with older but cheaper medications, long-term outcomes with newer agents, and even fasting blood glucose and hemoglobin A1c targets are just theoretical in many low-resource settings.We participate in a nonprofit organization that funds a medical clinic in a rural community in Honduras (2). We employ a full-time physician and nurse and a part-time dentist and pharmacy technician. One of our largest recurring costs is ...References1. Humphrey LL, Kansagara D, Qaseem A; High Value Care Committee of the American College of Physicians. World Health Organization guidelines on medicines for diabetes treatment intensification: commentary from the American College of Physicians High Value Care Committee. Ann Intern Med. 2018;169:398-400. [PMID: 30178054]. doi:10.7326/M18-1148 LinkGoogle Scholar2. Shoulder to Shoulder, Pittsburgh San-Jose. 2019. Accessed at www.shouldertoshoulderpgh.org on 12 March 2019. Google Scholar Author, Article, and Disclosure InformationAffiliations: University of Pittsburgh, Pittsburgh, Pennsylvania (C.B.G., N.R.K., M.M.)Disclosures: Authors have disclosed no conflicts of interest. Forms can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=L19-0068. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoWorld Health Organization Guidelines on Medicines for Diabetes Treatment Intensification: Commentary From the American College of Physicians High Value Care Committee Linda L. Humphrey , Devan Kansagara , Amir Qaseem , and World Health Organization Guidelines on Medicines for Diabetes Treatment Intensification Devan Kansagara , Linda L. Humphrey , and Amir Qaseem Metrics Cited byAssociation between Depression, Antidepression Medications, and the Risk of Developing Type 2 Diabetes Mellitus: A Nationwide Population-Based Retrospective Cohort Study in Taiwan 16 April 2019Volume 170, Issue 8Page: 583KeywordsGlobal healthGlucoseHypoglycemiaHypoglycemicsNursesPrevention, policy, and public healthProteinsResearch laboratoriesTechniciansTreatment guidelines ePublished: 16 April 2019 Issue Published: 16 April 2019 Copyright & PermissionsCopyright © 2019 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...