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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Registered doctors and pharmacists may claim 1 Continuing Medical Education (CME)/Continuing Professional Education (CPE) point under category 3A for reading each ACG.
| Key Messages |
| 1. |
Establish patient-centred glycaemic targets. |
| 2. |
Individualise treatment plans based on drug and patient profiles. |
| 3. |
Select metformin as the initial glucose-lowering agent as it has long-term efficacy and safety data. |
| 4. |
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. |
| 5. |
SGLT-2 inhibitors are appropriate for patients who are at risk of hypoglycaemia, are overweight, or with cardiovascular disease. |
| 6. |
Reserve DPP-4 inhibitors for patients with renal impairment.
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Oral glucose-lowering agents in T2DM (Updated on 3 August 2017)
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