The effects of diabetes mellitus include long-term damage, dysfunction and failure of various organs


Non-obese type 2 patients, consider the use of metformin or insulin secretagogues



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Non-obese type 2 patients, consider the use of metformin or insulin secretagogues

  • Metformin is the drug of choice in overweight/obese patients. TZDs and acarbose are acceptable alternatives in those who are intolerant to metformin.

  • If monotherapy fails, a combination of TZDs, acarbose and metformin is recommended. If targets are still not achieved, insulin secretagogues may be added



  • Combination oral agents is indicated in:

    • Combination oral agents is indicated in:

    • Newly diagnosed symptomatic patients with HbA1c >10

    • Patients who are not reaching targets after 3 months on monotherapy



    If targets have not been reached after optimal dose of combination therapy for 3 months, consider adding intermediate-acting/long-acting insulin (BIDS).

    • If targets have not been reached after optimal dose of combination therapy for 3 months, consider adding intermediate-acting/long-acting insulin (BIDS).


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