Treating type 2 diabetes is complicated. Supporting behavior change is the foundation of diabetes self-management. Medications are the next line of defense to prevent diabetes complications and get to the best health possible.

As providers and educators we are compelled be familiar with the wide range of medications that are currently available to treat diabetes. As patient advocates, we also perform a cost/benefit analysis to determine which medication would be the best match, considering cost, side effects and complexity.

There have been flurry of updates on existing medications. And many of the newly approved medications offer the hope of decreasing complexity, by combining 2 of different classes of medication in one shot. Plus, there are now four different concentrated insulins. Read on to learn more >>

Important Medication Updates

Metformin – new GFR renal threshold info approved by FDA.

• If GFR <30, do not use
• If GFR <45, don’t start metformin
• If pt on metformin and GFR falls to 30-45, eval risk vs. benefit and consider decreasing dose.

For dye study, if GFR <60, or with liver disease, alcoholism or heart failure, restart metformin after 48 hrs if renal function stable.

DPP-IV Inhibitors – New Warnings

• This class of med can cause disabling joint pain. Stop med, contact provider.
• Saxagliptin (Onglyza) and alogliptin (Nesina) can increase risk of heart failure. Notify provider if patient experiences shortness of breath, edema.

SGLT-2 Inhibitors – Considerations

• Can increase risk of ketoacidosis
• Empagliflozin (Jardiance) lowers all cause mortality 32%

To keep up with the latest medication updates, download our FREE Medication Pocket Cards