'Really Good' New Guidelines for T2 Diabetes

Editor's Note: The diabetes guidelines discussed below are a draft version of a consensus statement to be issued in October at the annual meeting of the European Association for the Study of Diabetes in Berlin, Germany.

Hi. I am Dr Anne Peters, and today I'm going to talk about the new ADA/EASD treatment guidelines for managing patients with type 2 diabetes. First off, my "headline" is that I think these are really good guidelines. Although guiding people is difficult, these guidelines actually begin to guide us in the treatment of our patients with type 2 diabetes.

They basically start the same way that all the old guidelines did, which is with lifestyle and metformin. That is really going to be our foundational therapy for our patients with type 2 diabetes.

Then, where they really differ from the old guidelines is, what is the second therapy? The first thing you do is ask, Does the patient have known cardiovascular disease or not?

If the answer is yes, they have known cardiovascular disease, then you enter a decision box in the algorithm to consider whether the patient has an eGFR of above or below 45. The recommendation is to start a medication that reduces