Clinician, Consumer Guides on Type 2 Diabetes, Autism Outline Therapy Options

Resources are Free for Physicians, Patients, Caregivers

August 09, 2011 05:05 pm News Staff

The Effective Health Care Program of the Agency for Healthcare Research and Quality, or AHRQ, recently posted free summary guides for clinicians and consumers that discuss treatment options for adults with type 2 diabetes and children with autism spectrum disorders.

[Patient Care]

Type 2 Diabetes

Comparing Medications for Adults With Type 2 Diabetes(www.effectivehealthcare.ahrq.gov) is an update to AHRQ's 2007 review of oral medications for type 2 diabetes. The clinician guide now includes information about newer medications and two-drug combinations. The document, which is based on an AHRQ comparative effectiveness review(www.effectivehealthcare.ahrq.gov) of 166 clinical studies, is intended to help physicians discuss treatment options with patients and assist them in decision-making.

The guide does not cover nonmedical interventions, such as nutrition, physical activity or weight loss.

The "Clinical Bottom Line" section of the guide includes the following findings:

  • on average, many monotherapies reduce hemoglobin A1c, or HbA1c, levels by 1 percent;
  • on average, two-drug combination therapies reduce HbA1c by 1 percent more than monotherapies;
  • metformin was associated with less weight gain compared with other monotherapies or combination therapies; and
  • glucagon-like peptide-1 receptor agonists were associated with less weight gain than were second-generation sulfonylureas.
Story Highlights

  • The Agency for Healthcare Research and Quality has released two sets of summary guides aimed at clinicians and consumers that discuss the treatment of adults with type 2 diabetes and therapies for children with autism.
  • Both sets of guides are based on comparative effectiveness reviews of more than 150 clinical studies and cover the risks and benefits associated with various treatment options.
  • The resources are available online, and free print copies also are available from the agency.

This section of the guide also discusses potential side effects, such as the fact that thiazolidinediones are associated with a higher risk of congestive heart failure compared with sulfonylureas, and thiazolidinediones alone or in combination with other drugs are associated with an increased risk of fractures compared with other medications.

The related consumer guide(www.effectivehealthcare.ahrq.gov) reviews the risks, benefits and costs of 11 brand-name diabetes medications and their generic equivalents, as well as seven drug combinations.

Autism Therapy

Comparative Effectiveness of Therapies for Children With Autism Spectrum Disorders(www.effectivehealthcare.ahrq.gov) is based on a review(www.effectivehealthcare.ahrq.gov) of 159 clinical studies. The clinician guide examines therapies for children ages 2-12 years that focus on improving key deficits in social communication, addressing challenging behaviors, treating commonly associated difficulties, promoting functional independence and improving quality of life.

The potential causes of autism are not addressed in the guide.

The "Clinical Bottom Line" section of the guide includes the following findings:

  • Evidence indicates that aripiprazole and, to a lesser extent, risperidone reduce challenging and repetitive behaviors compared with placebo. Both drugs, however, are associated with significant weight gain, sedation and extrapyramidal effects.
  • Secretin does not improve language, cognition, behavior, communication, autism symptom severity or socialization.
  • Evidence is insufficient to understand the effectiveness, benefits or adverse events from any allied health or complementary and alternative medicine interventions, any educational interventions and most behavioral interventions.

The related consumer guide(www.effectivehealthcare.ahrq.gov) provides an overview of the types of programs and therapies available to children, available evidence about each program or therapy, and questions to ask when planning therapies and programs.

Free print copies of the guides may be requested by e-mail or by calling the AHRQ Publications Clearinghouse at (800) 358-9295.


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