Type 2 Diabetes
Brown University, Providence, RI
The New England CEPAC, a core program of the Institute for Clinical and Economic Review (ICER), convened at a public meeting in October 2014 to discuss management options for patients with type 2 diabetes. ICER's report reviewd the comparative clinical effectiveness and value of multiple pharmacological options for second- and third-line treatment in patients with inadequate glycemic control on metformin monotherapy or a combination of metformin and a sulfonylurea, the most widely accepted initial medication choices for type 2 diabetes. The drug classes assessed in the review include: sulfonylureas, insulin, and two relatively new classes of medications, dipeptidyl peptidase-4 (DPP-4) inhibitors and glucagon-like peptide-1 (GLP-1) receptor agonists. The New England CEPAC also reviewed the evidence on multiple forms of insulin and methods for insulin delivery, as well as the potential benefits of continuous blood glucose monitoring in this population.