Oral Pharmacologic Treatment of Type 2 Diabetes Mellitus
Authors: David S.H. Bell
Journal: Annals of Internal Medicine (2017)

Letters4 July 2017Oral Pharmacologic Treatment of Type 2 Diabetes MellitusDavid S.H. Bell, MDDavid S.H. Bell, MDFrom Southside Endocrinology, New York, New York.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/L17-0233 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:Qaseem and colleagues' second recommendation states that when metformin fails to achieve therapeutic goals, clinicians should consider adding a sulfonylurea, thiazolidinedione, sodium–glucose cotransporter-2 inhibitor, or dipeptidyl peptidase-4 inhibitor, depending on benefits, adverse events, and cost (1). Although the authors do not prioritize these drugs, not listing them in alphabetical order implies that a sulfonylurea, the first drug mentioned, should be the next choice.The combination of metformin and a sulfonylurea may increase cardiac events. In the UKPDS (United Kingdom Prospective Diabetes Study), nonobese participants in whom sulfonylurea therapy was not successful after metformin was added had a ...References1. Qaseem A, Barry MJ, Humphrey LL, Forciea MA; Clinical Guidelines Committee of the American College of Physicians. Oral pharmacologic treatment of type 2 diabetes mellitus: a clinical practice guideline update from the American College of Physicians. Ann Intern Med. 2017;166:279-90. [PMID: 28055075]. doi:10.7326/M16-1860 LinkGoogle Scholar2. 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;352:854-65. [PMID: 9742977] CrossrefMedlineGoogle Scholar3. Evans JM, Ogston SA, Emslie-Smith A, Morris AD. Risk of mortality and adverse cardiovascular outcomes in type 2 diabetes: a comparison of patients treated with sulfonylureas and metformin. Diabetologia. 2006;49:930-6. [PMID: 16525843] CrossrefMedlineGoogle Scholar4. Bell DS, Patil HR, O'Keefe JH. Divergent effects of various diabetes drugs on cardiovascular prognosis. Rev Cardiovasc Med. 2013;14:e107-22. [PMID: 24448252] MedlineGoogle Scholar5. Garber AJ, Abrahamson MJ, Barzilay JI, Blonde L, Bloomgarden ZT, Bush MA, et al. AACE/ACE comprehensive diabetes management algorithm 2015. Endocr Pract. 2015;21:438-47. [PMID: 25877012] doi:10.4158/EP15693.CS CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From Southside Endocrinology, New York, New York.Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=L17-0233. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoOral Pharmacologic Treatment of Type 2 Diabetes Mellitus: A Clinical Practice Guideline Update From the American College of Physicians Amir Qaseem , Michael J. Barry , Linda L. Humphrey , Mary Ann Forciea , and Oral Pharmacologic Treatment of Type 2 Diabetes Mellitus Michael J. Barry , Linda L. Humphrey , and Amir Qaseem Oral Pharmacologic Treatment of Type 2 Diabetes Mellitus Silvio E. Inzucchi and Mikhail Kosiborod Metrics Cited byPostprandial Glycemic Dips Are Associated With Metabolic Disorders and CVD Risk in Euglycemic Individuals 4 July 2017Volume 167, Issue 1Page: 74-75KeywordsDisclosureDrugsMedical risk factorsMortalityPrimary careProspective studiesRetrospective studiesStable coronary artery diseaseSystolic pressureType 2 diabetes ePublished: 4 July 2017 Issue Published: 4 July 2017 Copyright & PermissionsCopyright © 2017 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...