This tool is designed to support primary care providers to prescribe and manage non-insulin pharmacotherapy for adult patients living with type 2 diabetes. This is an update of the original Achieving glycemic control in type 2 diabetes tool, released in 2012.
- Dose18: Initial: 250–500mg po daily cc; Usual: 1000mg po bid cc OR 1700mg cc am and 850mg cc pm; Max: 2550mg daily OR 850mg tid
- Renal dose12,18: eGFR 30-45mL/min (≤1000mg daily); eGFR <30mL/min (avoid*)
Comments12,18 (titration, administration, monitoring, notes)
- Titrate up every 1–2 weeks to avoid GI AE
- Take with largest meal to minimize GI AE
- 85% of max glucose lowering seen at 1500 mg daily
- Fewer GI side effects with ER formulation
- Monitor: hemoglobin and vitamin B12 deficiency (annually), SCr (baseline and periodically)
- On SADMANS list21
*Sometimes used at low dose when eGFR between 15-30 mL/min in renally stable patients