As blogged previously, the Canadian Diabetes Association released the 2013 Diabetes Guidelines in April this year. As part of the excellent CDA 2013 website, there is an app that can help health care providers choose the best medications to treat each patient with type 2 diabetes.
The reason for this app being developed is because after metformin (which is considered the best first line treatment), all other treatment options for type 2 diabetes are on an even spectrum without one in particular favored over another, with the best choice made in a patient-specific fashion. It is important to think about each patient’s individual characteristics, and medication characteristics, in choosing the next best treatment for your patient.
The app starts by asking the health care provider what the glucose control target is for their patient (A1C). Next is a quick yes/no checklist asking about other medical conditions that can impact the best choice for medication (eg bone disease, heart failure, pancreatitis history). The health care provider then clicks ‘INDIVIDUALIZE’, and the app will remove undesirable treatment options from the lengthy list of choices. The remaining agents in the table are the medications that you can then consider discussing with your patient. Under the table, the agents that have been removed as choices are listed, and the reason why they were removed is stated.
With all of the different medications available to treat type 2 diabetes (with new drug classes likely just around the corner as well), after metformin, it can seem a daunting task to choose the best agent(s) for our patient. This app lends a hand to help doctors narrow down the choices in a patient specific manner.
Dr Sue Pedersen www.drsue.ca © 2013
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