By vgreene, 10 January, 2019 To prevent delay progression to T2DM and maintain QOL Use lifestyle modifications consider metformin monitor regularly discuss DM technology assisted tools for self mgmt support
By vgreene, 10 January, 2019 Based on pt preference, consider DM technology-assisted tools to help prevent/delay onset of T2DM [B]
By vgreene, 10 January, 2019 Monitor at least annually E for the development of T2DM modify freq based on individual risk benefit assessment using informal risk assessment or an assessment tool see Diabetes Risk Score Type 2 in epocrates Calculators
By vgreene, 10 January, 2019 Metformin3 4 to prevent T2DM has the strongest evidence and long term safety profile consider if BMI 35 kg m2 age
By vgreene, 10 January, 2019 Refer pts w/ IGT, IFG,1 or A1C 5.7%-6.4%2 to intensive diet/physical activity behavioral counseling program targeting 7% body wt loss & increasing mod physical activity (eg, brisk walking) to at least 150min/wk [A]
By vgreene, 10 January, 2019 If further tx intensification needed (that is, HBA1c still above target) or pt unable to tolerate GLP-1 RA or SGLT2i, choose agents demonstrating CV safety:
By vgreene, 10 January, 2019 TZD (low dose may be better tolerated, but less well studied for CVD effects)