J Korean Diabetes.  2018 Mar;19(1):23-30. 10.4093/jkd.2018.19.1.23.

Combination Therapy of Oral Hypoglycemic Agents in Patients with Type 2 Diabetes Mellitus

• Moon MK

• KMID: 2408654
• DOI: http://doi.org/10.4093/jkd.2018.19.1.23

Abstract

The Korean Diabetes Association (KDA) recently updated the Clinical Practice Guidelines on antihyperglycemic agent therapy for adult patients with type 2 diabetes mellitus (T2DM). In combination therapy of oral hypoglycemic agents (OHAs), general recommendations were not changed compared to those of 2015 KDA guidelines. The committee of Clinical Practice Guideline of KDA has extensively reviewed and discussed the results of meta-analyses and systematic reviews of the effectiveness and safety of OHAs and many clinical trials on Korean patients with T2DM for the update of guidelines. All OHAs were effective when added to metformin or metformin and sulfonylurea, although the effects of each agent on body weight and hypoglycemia were different. Therefore, selection of a second agent as a metformin add-on therapy or a third agent as a metformin and sulfonylurea add-on therapy should be based on the patient's clinical characteristics and the efficacy, side effects, cardiovascular benefit, risk of hypoglycemia, effect on body weight, patient preference, and combined comorbidity.

Keyword

Diabetes mellitus; type 2; Hypoglycemic agents; combination; Practice guideline; Treatment outcome

MeSH Terms

Adult
Body Weight
Comorbidity
Diabetes Mellitus
Diabetes Mellitus, Type 2*
Humans
Hypoglycemia
Hypoglycemic Agents*
Metformin
Patient Preference
Treatment Outcome
Hypoglycemic Agents
Metformin

Figure

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  Fig. 1. Antihyperglycemic therapy algorithm for adult patients with type 2 diabetes mellitus. SGLT2i, sodium glucose cotransporter 2 inhibitors; TZD, thiazolidinedione; SU, sulfonylurea; DPP4i, dipeptidyl peptidase 4 inhibitors; GLP-1RA, glucagon-like peptide 1 receptor agonists; AGI, alpha glucosidase inhibitors.

Reference

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