This Appropriate Care Guide (ACG) highlights the importance of selecting agents based on drug and patient profiles to individualise care; and incorporates latest updates on oral glucose-lowering agents such as SGLT-2 inhibitors and DPP-4 inhibitors, their clinical and cost-effectiveness, safety and appropriate use in patients.
This ACG is currently under review to be updated based on the latest evidence where relevant.
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Oral glucose-lowering agents in T2DM (Updated on 3 August 2017)
||Establish patient-centred glycaemic targets.
||Individualise treatment plans based on drug and patient profiles.
||Select metformin as the initial glucose-lowering agent as it has long-term efficacy and safety data.
||Use second generation sulfonylureas when metformin is unsuitable or insufficient in achieving control. Avoid chlorpropamide and glibenclamide as they cause more hypoglycaemia than other sulfonylureas.
||SGLT-2 inhibitors are appropriate for patients who are at risk of hypoglycaemia, are overweight, or with cardiovascular disease.
||Reserve DPP-4 inhibitors for patients with renal impairment.
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