J Korean Diabetes.  2025 Mar;26(1):22-27. 10.4093/jkd.2025.26.1.22.

Selection of Pharmacological Treatments for Type 2 Diabetes Mellitus

• Moon SS

• KMID: 2567087
• DOI: http://doi.org/10.4093/jkd.2025.26.1.22

Abstract

The Korean Diabetes Association published the 2023 Clinical Practice Guidelines for Diabetes, which reflected recent clinical research on diabetes medications. The emergence of new medications effective in preventing and delaying cardiorenal complications has led to changes in the existing treatment paradigm. Reflecting this reality, in April 2023, the Health Insurance Review & Assessment Service exceptionally allowed triple therapy including sodium glucose cotransporter 2 (SGLT2) inhibitors. However, a gap still exists between revised medication recommendations and insurance coverage standards. Therefore, it is important for primary care providers to understand both the updated recommendations and insurance coverage criteria in order to effectively counsel their diabetic patients. Given this background, this article aims to summarize the key medication treatment recommendations from the 2023 Clinical Practice Guidelines for Diabetes and the relevant insurance reimbursement criteria from a primary care perspective.

Keyword

Diabetes mellitus; Hypoglycemic agents; Insurance; Practice guideline; Primary health care

Reference

1.Korean Diabetes Association. 2023 Clinical practice guidelines for diabetes. 8th ed.Seoul: Korean Diabetes Association;2023. p. 124–77.

2.Health Insurance Review & Assessment Service. Ministry of Health and Welfare Notification No. 2024-130. Available from: https://www.hira.or.kr/bbsDummy.do?p-gmid=HIRAA020002000100&brdScnBltNo=4&brdBlt-No=10980&pageIndex=1&pageIndex2=1.

3.Bennett WL., Maruthur NM., Singh S., Segal JB., Wilson LM., Chatterjee R, et al. Comparative effectiveness and safety of medications for type 2 diabetes: an update including new drugs and 2-drug combinations. Ann Intern Med. 2011. 154:602–13.

4.ElSayed NA., Aleppo G., Aroda VR., Bannuru RR., Brown FM., Bruemmer D., American Diabetes Association, et al. 9. Pharmacologic approaches to glycemic treatment: standards of care in diabetes-2023. Diabetes Care. 2023. 46(Suppl 1):S140–57.

5.UK Prospective Diabetes Study (UKPDS) Group. Effect of intensive blood-glucose control with metformin on complications in overweight patients with type 2 diabetes (UKPDS 34). Lancet. 1998. 352:854–65.

6.Matthews DR., Paldánius PM., Proot P., Chiang Y., Stumvoll M., Del Prato S; VERIFY study group. Glycaemic durability of an early combination therapy with vildagliptin and metformin versus sequential metformin monotherapy in newly diagnosed type 2 diabetes (VERIFY): a 5-year, multicentre, randomised, double-blind trial. Lancet. 2019. 394:1519–29.

7.Schectman JM., Nadkarni MM., Voss JD. The association between diabetes metabolic control and drug adherence in an indigent population. Diabetes Care. 2002. 25:1015–21.

8.Yang W., Cai X., Wu H., Ji L. Associations between metformin use and vitamin B12 levels, anemia, and neuropathy in patients with diabetes: a meta-analysis. J Diabetes. 2019. 11:729–43.

9.Out M., Kooy A., Lehert P., Schalkwijk CA., Stehouwer CDA. Long-term treatment with metformin in type 2 diabetes and methylmalonic acid: post hoc analysis of a randomized controlled 4.3 year trial. J Diabetes Complications. 2018. 32:171–8.