Jul 15, 2009 Issue
Risk-Assessment Tools for Detecting Undiagnosed Diabetes [Point-of-Care Guides]

Early intervention with lifestyle modifications or pharmacotherapy has been shown to effectively delay or prevent type 2 diabetes in adults.

Mar 1, 2009 Issue
Dipeptidyl-peptidase-4 Inhibitors for Treatment of Type 2 Diabetes [Cochrane for Clinicians]

When used as monotherapy or in conjunction with metformin (Glucophage) or thiazolidinediones, the DPP-4 inhibitor sitagliptin (Januvia) decreases A1C levels by 0.7 percent, but there are no data on patient-oriented outcomes or long-term safety. Until more studies are completed, it should only be use...

Jan 1, 2009 Issue
Management of Blood Glucose in Type 2 Diabetes Mellitus [Article]

Evidence-based guidelines for the treatment of type 2 diabetes mellitus focus on three areas: intensive lifestyle intervention that includes at least 150 minutes per week of physical activity, weight loss with an initial goal of 7 percent of baseline weight, and a low-fat, reduced-calorie diet; aggr...

Jul 15, 2008 Issue
Becaplermin (Regranex) for Diabetic Foot Ulcers [STEPS]

Although patients treated with becaplermin are more likely to experience complete and faster ulcer healing than patients continuing good wound care alone, the increased risk of cancer mortality and significant cost outweigh the possible benefits in most patients.

Jul 1, 2008 Issue
Diabetic Foot Infection [Article]

Foot infections are common in patients with diabetes and are associated with high morbidity and risk of lower extremity amputation. Diabetic foot infections are classified as mild, moderate, or severe. Gram-positive bacteria, such as Staphylococcus aureus and beta-hemolytic streptococci, are the mos...

Jun 15, 2008 Issue
Gastrointestinal Complications of Diabetes [Article]

Gastrointestinal complications of diabetes include gastroparesis, intestinal enteropathy (which can cause diarrhea, constipation, and fecal incontinence), and nonalcoholic fatty liver disease. Patients with gastroparesis may present with early satiety, nausea, vomiting, bloating, postprandial fullne...

Feb 15, 2008 Issue
Are Long-acting Insulin Analogues Better Than Isophane Insulin? [Cochrane for Clinicians]

Based on poor quality evidence, this review suggests that insulin glargine and insulin detemir have no advantage over isophane insulin in reducing A1C levels. In one study, isophane insulin reduced A1C levels slightly more than insulin detemir. However, patients on insulin glargine and detemir repor...

Jan 1, 2008 Issue
Choosing First-Line Therapy for Management of Type 2 Diabetes [AFP Journal Club]

Which controls type 2 diabetes best at five years: rosiglitazone, metformin, or glyburide? Metformin should be the first-line drug for managing type 2 diabetes. Insulin and sulfonylureas should be second line, and glitazones should be reserved for third line.

Oct 1, 2007 Issue
Does Pioglitazone Benefit Patients With Type 2 Diabetes? [Cochrane for Clinicians]

Pioglitazone produces a reduction in A1C levels similar to that produced by other drugs. One trial found that although pioglitazone, used as an adjunct to other antihyperglycemic medications, may lead to a statistically significant reduction in morbidity and mortality in patients with established ma...

Sep 15, 2007 Issue
Sitagliptin (Januvia) for the Treatment of Patients with Type 2 Diabetes [STEPS]

Sitagliptin may be useful as second-line or third-line therapy in patients with a mildly elevated A1C level (less than 9 percent) who do not reach their A1C goal with first-line therapy (metformin). Sitagliptin will decrease postprandial blood glucose and mildly lower fasting blood glucose for a total A1C reduction around 0.8 percent.

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