Algorithm for Sequencing Glucose-Lowering Therapies in Type 2 Diabetes

Mohammed Al-Sofiani, M.B.B.S, Anda Gonciulea, M.D., Rita Rastogi Kalyani, M.D., M.H.S.


  • Glycemic management in type 2 diabetes is complex and evolving, with many new therapies for type 2 diabetes having been introduced over the past few years.
  • More recent guidelines emphasize a patient-centered approach and also take into consideration patient factors when choosing therapies and appropriate glycemic goals (i.e. patient involvement and expected efforts; comorbidities, especially established vascular complications; disease duration; life expectancy).
  • Other factors to consider when choosing therapies for type 2 diabetes might include: efficacy, cost, available resources and support system, fasting versus postprandial hyperglycemia, risk of hypoglycemia, weight changes, drug side effects, route of administration, and drug’s mechanism of action.

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Last updated: June 4, 2018