2019 Update to: Management of Hyperglycemia in Type 2 Diabetes, 2018. A Consensus Report by the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD)

Diabetes Care. 2020 Feb;43(2):487-493. doi: 10.2337/dci19-0066. Epub 2019 Dec 19.

Abstract

The American Diabetes Association and the European Association for the Study of Diabetes have briefly updated their 2018 recommendations on management of hyperglycemia, based on important research findings from large cardiovascular outcomes trials published in 2019. Important changes include: 1) the decision to treat high-risk individuals with a glucagon-like peptide 1 (GLP-1) receptor agonist or sodium-glucose cotransporter 2 (SGLT2) inhibitor to reduce major adverse cardiovascular events (MACE), hospitalization for heart failure (hHF), cardiovascular death, or chronic kidney disease (CKD) progression should be considered independently of baseline HbA1c or individualized HbA1c target; 2) GLP-1 receptor agonists can also be considered in patients with type 2 diabetes without established cardiovascular disease (CVD) but with the presence of specific indicators of high risk; and 3) SGLT2 inhibitors are recommended in patients with type 2 diabetes and heart failure, particularly those with heart failure with reduced ejection fraction, to reduce hHF, MACE, and CVD death, as well as in patients with type 2 diabetes with CKD (estimated glomerular filtration rate 30 to ≤60 mL min-1 [1.73 m]-2 or urinary albumin-to-creatinine ratio >30 mg/g, particularly >300 mg/g) to prevent the progression of CKD, hHF, MACE, and cardiovascular death.

Publication types

  • Historical Article
  • Practice Guideline
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Cardiovascular Diseases / blood
  • Cardiovascular Diseases / prevention & control
  • Consensus
  • Diabetes Complications / blood
  • Diabetes Complications / drug therapy
  • Diabetes Complications / prevention & control
  • Diabetes Mellitus, Type 2 / blood*
  • Diabetes Mellitus, Type 2 / complications
  • Diabetes Mellitus, Type 2 / therapy*
  • Europe
  • History, 21st Century
  • Humans
  • Hyperglycemia / blood
  • Hyperglycemia / etiology
  • Hyperglycemia / therapy*
  • Hypoglycemic Agents / classification
  • Hypoglycemic Agents / therapeutic use
  • Male
  • Renal Insufficiency, Chronic / blood
  • Renal Insufficiency, Chronic / drug therapy
  • Societies, Medical / organization & administration
  • Societies, Medical / standards
  • Sodium-Glucose Transporter 2 Inhibitors / therapeutic use
  • United States

Substances

  • Hypoglycemic Agents
  • Sodium-Glucose Transporter 2 Inhibitors