Non-insulin treatment for A1C reduction in Type 2 diabetes
Current ADA guidelines recommend:
- A1C goal for nonpregnant adults of <7% (53 mmol/mol) without significant hypoglycemia is appropriate.
- Achievement of lower A1C levels than 7% may be acceptable, and even beneficial, if achieved safely without significant hypoglycemia or other adverse effects.
- A1C goals of <8% [64 mmol/mol] or higher may be appropriate for patients with limited life expectancy, or where the risks outweigh the benefits.
Current ADA guidelines recommend that the medication regimen and medication-taking behavior should be reevaluated at regular intervals (every 3–6 months) and adjusted as needed to incorporate specific factors that impact treatment choice.
How long after starting a diabetes medication do you wait to see if the patient needs to switch or escalate to other non-insulin anti-diabetic treatments?
What are the key considerations when deciding to switch or escalate to other non-insulin anti-diabetic treatments?
Will review blood glucose record if they are keeping one
If tolerating medication will make adjustments based on the last HbA1C, the expected HbA1C reduction of the new medication. May start another agent at that point
Usually checking HbA1C every 3 months
Cost is major consideration in selection of medications and other medical conditions the patient may have
Will review blood glucose record if they are keeping one
If tolerating medication will make adjustments based on the last HbA1C, the expected HbA1C reduction of the new medication. May start another agent at that point
Usually checking HbA1C every 3 months
Cost is major consideration in selection of medications and other medical conditions the patient may have
Keys consideration to change meds or to escalate would be, med intolerance, allergy, not approved by Insurance and clinically, if despite appropriate use and accompanying low carb diet and daily exercises, pt's insulin resistance is high and HbA1c still 8.5 or higher. At this point with a HbA1c of 8.5 or higher Insulin will need to be started and patient educated on self administration technique and daily adjusting of Insulin, if basal Insulin is started.
Keys consideration to change meds or to escalate would be, med intolerance, allergy, not approved by Insurance and clinically, if despite appropriate use and accompanying low carb diet and daily exercises, pt's insulin resistance is high and HbA1c still 8.5 or higher. At this point with a HbA1c of 8.5 or higher Insulin will need to be started and patient educated on self administration technique and daily adjusting of Insulin, if basal Insulin is started.
Keys consideration to change meds or to escalate would be, med intolerance, allergy, not approved by Insurance and clinically, if despite appropriate use and accompanying low carb diet and daily exercises, pt's insulin resistance is high and HbA1c still 8.5 or higher. At this point with a HbA1c of 8.5 or higher Insulin will need to be started and patient educated on self administration technique and daily adjusting of Insulin, if basal Insulin is started.
Keys consideration to change meds or to escalate would be, med intolerance, allergy, not approved by Insurance and clinically, if despite appropriate use and accompanying low carb diet and daily exercises, pt's insulin resistance is high and HbA1c still 8.5 or higher. At this point with a HbA1c of 8.5 or higher Insulin will need to be started and patient educated on self administration technique and daily adjusting of Insulin, if basal Insulin is started.
insulin will recheck in about a month
insulin will recheck in about a month
insulin will recheck in about a month
insulin will recheck in about a month
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