Diabetes treatment gets personal

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People with type 2 diabetes will benefit from a more individualized approach to their treatment, according to a joint statement from American and European diabetes societies. Both groups now recommend that target blood sugar levels (as measured by glycated hemoglobin levels) and drug treatments be tailored to each patient's needs and preferences, rather than the previous policy of a fixed algorithm of treatment progressions. The new position statement was issued by the American Diabetes Association (ADA) and the European Association for the Study of Diabetes, published in both Diabetes Care and Diabetologia.

Currently, clinicians rely on a treatment algorithm that was developed by these two diabetes organizations. However, the 2006 guideline was written when there were less data on medications now commonly in use. The 2012 position statement, the first issued by the ADA, recognizes the numerous classes of FDA-approved medications available; consequently, the statement recommends no specific treatment agent after metformin, the first-line drug for the treatment of type 2 diabetes. Other significant changes to this more patient-focused approach include patient education that emphasizes diet and exercise in order to achieve the lifestyle changes that remain the first step in managing diabetes.

ACSH's Dr. Gilbert Ross observes that the position statement rightly follows the increasingly common approach of tailoring medical treatments to a patient's specific needs. And Dr. Judith Stern, ACSH scientific advisor and emerita professor of nutrition at the University of California at Davis, says that she applauds "the ADA for their twenty-first century advice to tailor therapy to the patient. One size clearly does not fit all."