Type 2 Diabetes Medication Review.

BACKGROUND: Patients with type 2 diabetes and their healthcare providers have a variety of medication options available for treating elevated blood glucose values. These medication choices have expanded drastically over the last 10 years with a large number of glucose lowering medications gaining FDA approval. METHODS: Here, we have included an extensive search of the type 2 diabetes literature focusing on articles which impact patient-oriented evidence that maters (POEMs). RESULTS: Choosing the best agent(s) can be challenging and requires weighing the risks and benefits of each particular medication. Tailoring medications to individual patients should be prioritized based on trials with cardiovascular outcome data, potential hemoglobin A1c reduction/goal, serious medication precautions and side-effects, co-morbid medical conditions, and cost. CONCLUSIONS: This paper will provide the reader with an overview of the pros and cons for each antiglycemic medication class and specific drugs where appropriate. Data relevant to most patient centered encounters will be provided, including safety, tolerability, efficacy, cost, and simplicity of use.

Event reduction: revisiting why we treat with statins and harnessing current evidence towards optimal therapy.

IMPORTANCE OF THE FIELD: Statins are widely accepted as the drugs of choice for achieving increasingly stringent low-density lipoprotein cholesterol (LDL-C) goals for dyslipidemic patients. However, when making treatment decisions, outcomes data from clinical trials are of greater importance than LDL-C-lowering ability. AREAS COVERED IN THIS REVIEW: This review will provide an update on current lipid treatment guidelines in the context of statin trial evidence, with particular focus on the incremental benefit of more potent statin therapy compared with lower doses. The discussion will also address combination therapy, statin safety, goal attainment and treatment adherence. MEDLINE searches (1966 to July 2010) were performed. WHAT THE READER WILL GAIN: The reader will gain a comprehensive review of the evidence base for statin therapy and an appreciation of other issues that affect treatment choice. TAKE HOME MESSAGE: It is important to remember why we need to partner with our patients: to ensure that they are established on, and continue to adhere to, their appropriate evidence-based statin dose with a goal of achieving lipid targets, but more importantly to prevent cardiovascular disease-related morbidity and mortality. We treat patients to reduce clinical cardiovascular events, not just to control lipids and other important risk factors.