Diabetes Treatment Algorithm
Complications-Centric Model : A Paradigm Shift in Diabetes Care
In the realm of diabetes management, the 2023 algorithm’s focus on a “complication-centric” approach implies that there’s been a significant shift in how treatment options are chosen for diabetic patients. Instead of relying solely on glucose levels to determine appropriate pharmacotherapy, this new approach seems to incorporate a broader array of patient-specific factors, particularly complications related to diabetes.
In essence, this would make treatment plans far more personalized and could potentially improve outcomes for patients. This is because treatment can be tailored not just to control their blood glucose levels but also to prevent or slow down the progression of diabetes-related complications, depending on the individual’s specific risks and overall health status.
Moreover, it implies a preventive approach to managing the disease, focusing not only on current symptoms and blood sugar levels but also on mitigating future risks. This shift is in line with a broader trend in medicine towards personalized and preventive care.
Overall, the 2023 algorithm signifies a major advancement in the management of diabetes, one that could significantly improve the quality of life for people with this condition. As always, it would be important for each patient to consult with their healthcare provider to understand what this shift means for their individual care plan.
Glucose Centric Model
Individuals without cardiovascular (CV) complications, or those with CV complications who have not achieved their desired blood sugar levels using the complications-focused strategy, should switch to a treatment plan primarily focused on glucose management. This method starts with lifestyle changes, incorporates metformin if deemed suitable, and sets a personalized Hemoglobin A1c (HbA1c) target, mirroring the approach used in the complications-centric method.
Regarding medication, individuals who are overweight, obese, or at a heightened risk for hypoglycemia should be administered a combination of GLP-1 and GIP/GLP-1 dual agonists, or an SGLT2. For those adults who have concerns about the cost or availability of medication, generic options can be considered as an alternative.
Download infographics of the AACE guidelines from Guideline Central.
Samson SL, Vellanki P, Blonde L, Christofides EA, Galindo RJ, Hirsch IB, Isaacs SD, Izuora KE, Low Wang CC, Twining CL, Umpierrez GE, Valencia WM. American Association of Clinical Endocrinology Consensus Statement: Comprehensive Type 2 Diabetes Management Algorithm – 2023 Update. Endocr Pract. 2023 May;29(5):305-340. doi: 10.1016/j.eprac.2023.02.001.
This was first published on June 11, 2023 and Last Updated on June 11, 2023 by MyEndoConsult