Additional therapies

Type 2 diabetes mellitus: Quality prescribing strategy - a guide for improvement
Scottish Government Effective Prescribing & Therapeutics Division
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(See local formularies/SPC/BNF for 2nd/3rd line choices and licensed indications)

  • SGLT-2i (an option in dual/triple therapy)
  • GLP-1RA (third line, see local formulary)
  • SU (hypoglycaemic risk)
  • DPP-4i
  • Pioglitazone (caution in HF)

Refer to Table 6 to aid choice (efficacy, weight loss/gain, hypoglycaemia, renal impairment, long-term outcomes)

 

Review 3 monthly until at target.

When therapy has not continued to control HBA1c, consider insulin (following local process for initiation).