Building Competency in Diabetes Education THE ESSENTIALS

TREATMENT MODALITIES: PHARMACOLOGICAL THERAPIES | 6- 4. ADJUST or ADVANCE THERAPY WHERE GLUCOSE LOWERING IS REQUIRED When additional glucose lowering is required beyond metformin, and after consideration is given to the person’s cardiovascular and renal status (and cardiorenal antihyperglycemic agent is appropriately started), Figure 2.2 can be consulted to support individualization of therapy. The selection of antihyperglycemic agent(s) should be individualized based on matching the person’s individual metabolic needs, personal goals lifestyle(24) and level of frailty with the agent characteristics, including demonstrated cardiorenal benefit, risk of weight gain and hypoglycemia, and side effect profile.

Figure 2.2 is an image that depicts the clinical considerations of an adult with type 2 diabetes and the antihyperglycemic agent characteristics.

A. High-Risk Populations: Individuals with established atherosclerotic cardiovascular disease, chronic kidney disease, heart failure or who are 60 years or older with at least 2 CV ris factors requiring additional glucose lowering • reinforce healthy behaviour interventions and lifestyle choices expected to lower blood glucose levels • In 2. “ ASSESS FOR “CHANGE IN CLINICAL STATUS”, i.e. HIGH-RISK POPULATIONS", the individual would already have been started on a GLP-1 RA or SGLT2i with proven