Comparing Medications for Type 2 Diabetes: What's Known

Charles P. Vega, MD


August 30, 2011

In This Article

Clinical Pearls

  • Diet and exercise can significantly improve A1c values among patients with type 2 diabetes, but they cannot be expected to reduce A1c more than 1%.

  • There are little data to guide clinicians on treatment of type 2 diabetes based on efficacy in preventing major complications of diabetes or death.

  • Most monotherapy for type 2 diabetes can be expected to reduce A1c values by approximately 1%.

  • Adding additional therapy to single medications for diabetes can be expected to reduce A1c values by an additional 1%.

  • Metformin is a good first-choice medication for the treatment of type 2 diabetes. Long-acting sulfonylureas should be avoided in high-risk patients.

  • In general, high-risk patients have a target A1c level of less than 7%. Younger patients without comorbid conditions may be treated to a lower A1c target.


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