Type 2 Diabetes: Sequencing Therapies

DEFINITION

• Treatment of hyperglycemia in diabetes should be progressively intensified as necessary to control blood glucose to target ranges.
• This requires, first, establishing goals, especially for hemoglobin A1c and avoidance of unacceptable hypoglycemia.
• It then requires adjusting therapy to reach those targets.
• Recommendations should be considered in the context of the needs, preferences, and tolerances of each patient.
• Patient-centered care should be an organizing principle. It is defined as an approach to "providing care that is respectful of and responsive to individual patient preferences, needs, and values and ensuring that each patient values guide all clinical decisions."^[1]
• Ultimately it is the patient that make the final decisions regarding their lifestyle choices; their implementation occurs in the context of patients’ day-to-day life.