J Korean Diabetes > Volume 20(3); 2019 > Article
The Journal of Korean Diabetes 2019;20(3):142-148.
DOI: https://doi.org/10.4093/jkd.2019.20.3.142    Published online October 2, 2019.
제2형 당뇨병 환자의 경구약물요법
고승현
Oral Hypoglycemic Agents for Patients with Type 2 Diabetes Mellitus.
Seung Hyun Ko
Division of Endocrinology and Metabolism, Department of Internal Medicine, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea. kosh@catholic.ac.kr
Abstract
For patients with newly diagnosed type 2 diabetes mellitus (T2DM), lifestyle modifications including medical nutrition therapy, weight control, physical activity, smoking cessation, and avoidance of alcohol abuse should be initiated. Metformin must be considered as the first-line oral glucose-lowering therapy, but other drugs such as dipeptidyl peptidase 4 (DPP-4) inhibitors, sodium-glucose cotransporter 2 (SGLT-2) inhibitors, thiazolidinediones, glucagon-like peptide 1 receptor agonists, sulfonylureas, glinides, α-glucosidase inhibitors, and insulin can be considered based on patient circumstances. If the initial HbA1c level of a patient is ≥ 7.5% or the HbA1c target is not achieved within three months of initiating monotherapy, dual combination therapy can be considered. If the HbA1c target is not achieved within 3 months of initiating dual therapy, a third agent with a complementary mechanism of action can be added for triple combination therapy. In addition, evidence from large clinical studies assessing cardiovascular outcomes following the use of SGLT-2 inhibitors in T2DM patients with cardiovascular risk factors have been incorporated into the updated recommendations.
Key Words: Diabetes mellitus, Type 2, Hypoglycemic agents, Practice guideline


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