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A new blood glucose management algorithm for type 2 diabetes: a position statement of the Australian Diabetes Society

Jenny E Gunton, N Wah Cheung, Timothy M E Davis, Sophia Zoungas and Stephen Colagiuri
Med J Aust 2014; 201 (11): 650-653. || doi: 10.5694/mja14.01187

Summary

  • Lowering blood glucose levels in people with type 2 diabetes has clear benefits for preventing microvascular complications and potential benefits for reducing macrovascular complications and death.
  • Treatment needs to be individualised for each person with diabetes. This should start with selecting appropriate glucose and glycated haemoglobin targets, taking into account life expectancy and the patient's wishes. For most people, early use of glucose-lowering therapies is warranted.
  • A range of recently available therapies has added to the options for lowering glucose levels, but this has made the clinical pathway for treating diabetes more complicated.
  • This position statement from the Australian Diabetes Society outlines the risks, benefits and costs of the available therapies and suggests a treatment algorithm incorporating the older and newer agents.

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  • Jenny E Gunton1
  • N Wah Cheung2
  • Timothy M E Davis3
  • Sophia Zoungas4
  • Stephen Colagiuri5

  • 1 Western Clinical School, University of Sydney, Sydney, NSW.
  • 2 Department of Diabetes and Endocrinology, Westmead Hospital, Sydney, NSW.
  • 3 School of Medicine and Pharmacology, University of Western Australia, Perth, WA.
  • 4 Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC.
  • 5 Boden Institute of Obesity, Nutrition, Exercise and Eating Disorders, University of Sydney, Sydney, NSW.


Acknowledgements: 

We thank Jennifer Conn and Merryl Koschade for help with reformatting the treatment algorithm, and the ADS membership for their comments on the position statement.

Competing interests:

Jenny Gunton is a member of the Pharmaceutical Benefits Advisory Committee. She received speakership honoraria for two Novo Nordisk-sponsored meetings with independent program organising committees in 2012–13. Wah Cheung has received a speakership honorarium from the Chinese Endocrine Society, which was provided by Sanofi. Timothy Davis has served on advisory boards for and received research funding, speaker fees and travel assistance to attend meetings from Merck Sharp & Dohme, Novartis, Novo Nordisk and Sanofi Aventis; has served on advisory boards for and received speaker fees and travel assistance to attend meetings from AstraZeneca and Boehringer Ingelheim; and has served on advisory boards for and received research funding and speaker fees from Takeda. Sophia Zoungas has served on advisory boards for Amgen Australia, AstraZeneca/Bristol-Myers Squibb, Merck Sharp & Dohme, Novartis, Sanofi and Takeda; has received consultancy fees and honoraria from AstraZeneca/Bristol-Myers Squibb, Janssen-Cilag, Merck Sharp & Dohme and Servier; and has conducted institutional contract work for Bristol-Myers Squibb. Over the past 3 years, Stephen Colagiuri sat on advisory boards for and/or received speaking fees from AstraZeneca, Bristol-Myers Squibb, GlaxoSmithKline, Janssen-Cilag, Merck Sharp & Dohme, Medtronics, Novartis, Novo Nordisk, Sanofi Aventis, Servier and Takeda.

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