The Medical Letter on Drugs and Therapeutics
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1512
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Drugs for Type 2 Diabetes
Revised 5/17/18: Information on newly approved drugs, recently published clinical trials, and cardiovascular outcomes have been changed.
Revised 11/13/17: The price for Victoza was changed to $498.40 (from $249.20).
Revised 1/12/17: In the dulaglutide section, we mistakenly stated that Xultophy is a combination of albiglutide/insulin degludec; the correct combination of Xultophy is liraglutide/insulin degludec. We have also moved that sentence to the liraglutide paragraph.

The goal of drug therapy for type 2 diabetes is to achieve and maintain a near-normal glycated hemoglobin (A1C) concentration without inducing hypoglycemia; the target is generally an A1C of <7%.1 Treating to this target has been shown to prevent microvascular complications (retinopathy, nephropathy, and neuro pathy), but whether it prevents macrovascular outcomes is unclear. An A1C target of <8% may be appropriate for older patients and those with underlying cardiovascular disease, a history of severe hypoglycemia, diabetes-related complications or comorbidities, or a long duration of disease.2,3

LIFESTYLE MODIFICATIONS — Diet, exercise, and weight loss can improve glycemic control and are recommended for all patients, but most patients with type 2 diabetes ultimately require drug therapy. In a 10-year randomized controlled trial in ... more      

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