The American Diabetes Association (ADA) has stepped up its treatment recommendations for patients with type 2 diabetes. Lifestyle changes and the drug metformin are used for initial treatment to control glucose and A1C levels. If this does lower glucose levels to target levels there are two treatment choices. The first is adding basal insulin or a sulfonylurea to the initial treatment, and the second choice involves adding the drug pioglitazone or a GP-1 agonist to the initial treatment. If glucose levels are still not controlled, intensive insulin may be added to these treatments.
 
These transitions in therapy occur in three-month intervals to achieve quick and continuous control of glucose and A1C levels.This strict regiment is aimed to prevent long-term complications associated with diabetes, including kidney failure, vision loss and amputation.

This article originally appeared in the November 2008 issue of Kidney Beginnings: The Electronic Newsletter.