By vgreene, 7 March, 2019 Reassess/individualize glycemic targets over time based on modifiable/non-modifiable patient/dz features3 [E]
By vgreene, 7 March, 2019 Don’t delay intensified tx for pts not meeting tx goals [B]; in most pts requiring greater glucose-lowering effect of injectable med, GLP-1 RA preferred over insulin [B]
By vgreene, 7 March, 2019 Monitor HbA1C: at least twice yearly if pt meeting goals/stable glycemic control; quarterly if not meeting goals or tx has changed; point-of-care testing allows for more-timely tx changes [E]
By vgreene, 7 March, 2019 Consider early combo tx at tx initiation in some pts to extend time to tx failure [A]
By vgreene, 7 March, 2019 If evidence of catabolism (wt loss, ketosis), sx of hyperglycemia (ie, polyuria, polydipsia), and/or A1C ≥10% or blood glucose ≥300 mg/dL: Consider early initiation of insulin [E]
By vgreene, 7 March, 2019 1st line tx depends on comorbidities pt centered treatment factors mgmt needs generally includes metformin1 and comprehensive lifestyle modification but other agents may also be appropriate initial choice A