Abstract
The ADA/EASD consensus 2022 and its implications for Belgium During the European Association for the Study of Diabetes (EASD) congress in Stockholm, the new consensus guideline for the treatment of hyperglycemia in type 2 diabetes was presented. The American Diabetes Association (ADA) and the EASD plead for a holistic, patient-centered approach surrounded by a team of healthcare professionals. The consensus focuses on a patient-tailored pharmacological and non-pharmacological approach taking into account patient-specific comorbidities. Striving for sustainable weight reduction should be the cornerstone of any therapeutic intervention in type 2 diabetes. The early initiation of combination therapy is recommended to avoid therapeutic inertia and to increase the time to therapeutic failure. Sodium-glucose cotransporter-2 inhibitors (SGLT2i) and glucagon-like peptide-1 receptor agonists (GLP1-RA) remain the first choice for patients with established cardiorenal disease or high-risk patients, possibly in combination with metformin. In the absence of cardiovascular or renal disease, the medication selection should be driven by weight control, obtaining glycemic control and the avoidance of hypoglycemia. Here again, SGLT2i and GLP1-RA shine because of their good safety profile and highly favorable effects on weight, glucose and blood pressure. Thanks to the b(l)ooming development of new antidiabetic medication for type 2 diabetes, adding insulin to the treatment plan can often be postponed to later stages of the disease. When insulin is required, the combined initiation with a GLP1-RA should be considered as they allow lower glycemic targets to be reached with a lower injection burden, a lower risk of hypoglycemia and lower weight gain than with insulin alone.
Published Version
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