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)

• Published in: Diabetes care Vol. 43; no. 2; pp. 487 - 493
• Main Authors: Buse, John B., Wexler, Deborah J., Tsapas, Apostolos, Rossing, Peter, Mingrone, Geltrude, Mathieu, Chantal, D’Alessio, David A., Davies, Melanie J.
• Format: Journal Article
• Language: English
• Published: United States American Diabetes Association 01.02.2020
• Subjects: Agonists; Albumins; Cardiovascular diseases; Cardiovascular Diseases - blood; Cardiovascular Diseases - prevention & control; Clinical trials; Consensus; Consensus Report Update; Creatinine; Death; Diabetes; Diabetes Complications - blood; Diabetes Complications - drug therapy; Diabetes Complications - prevention & control; Diabetes mellitus; Diabetes mellitus (non-insulin dependent); Diabetes Mellitus, Type 2 - blood; Diabetes Mellitus, Type 2 - complications; Diabetes Mellitus, Type 2 - therapy; Ejection fraction; Europe; Glomerular filtration rate; GLP-1 receptor agonists; Glucagon; Glucagon-like peptide 1; Health risk assessment; Heart diseases; Heart failure; History, 21st Century; Humans; Hyperglycemia; Hyperglycemia - blood; Hyperglycemia - etiology; Hyperglycemia - therapy; Hypoglycemic Agents - classification; Hypoglycemic Agents - therapeutic use; Kidney diseases; Male; Mortality; Renal Insufficiency, Chronic - blood; Renal Insufficiency, Chronic - drug therapy; Societies, Medical - organization & administration; Societies, Medical - standards; Sodium-glucose cotransporter; Sodium-Glucose Transporter 2 Inhibitors - therapeutic use; United States; United States; Europe
• ISSN: 0149-5992; 1935-5548; 1935-5548
• DOI: 10.2337/dci19-0066

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.