Second steps in managing type 2 diabetes

2型糖尿病管理的第二步

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Abstract

In type 2 diabetes, diet, exercise and attaining a healthy weight should be encouraged at every opportunity Metformin is the usual first-line drug management Sulfonylureas are appropriate as second-line drugs for many patients. Other oral drugs are preferable if weight gain or hypoglycaemia are significant problems If a combination of metformin and a sulfonylurea is not suitable, either a dipeptidyl peptidase-4 inhibitor or sodium-glucose co-transporter 2 inhibitor can be prescribed. The patient characteristics and the beneficial and adverse effects of the drug should be considered when selecting second-line therapy Due to their adverse-effect profiles, thiazolidinediones and acarbose should be reserved for patients with contraindications to all other oral drugs, and those who will not tolerate injectable drugs

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