The Comparative Effectiveness Public Advisory Council (CEPAC) has released a final evidence report on the effectiveness and value of add-on use of certain medications and treatment options in type-2 diabetes management.
Type 2 diabetes management has received significant attention over the past decade due to its increasing prevalence and rise in costs associated with its treatment.
Approximately 30m Americans have diabetes, of which 95% have the type 2 form. In 2012, the annual cost of managing diabetes was estimated to total $245bn, including both direct medical costs and lost productivity resulting from complications. This estimate represents a 41% increase in diabetes-related expenditures since 2007.
Increasing costs are in part due to the emergence of novel therapies and management tools for diabetes, including newer and costlier forms of insulin, insulin pump therapy, new classes of oral medications, and devices for the intensive monitoring of blood glucose.
Though metformin is widely accepted as the best first-line medication for type 2 diabetes, a number of questions remain regarding management options for patients with more complex disease, including: the relative advantages and risks associated with different pharmacologic combination therapies, including newer drug classes like DPP-4 inhibitors and GLP-1 receptor agonists; the best strategies for initiating insulin treatment; the comparative clinical effectiveness and value of different insulin options, including insulin choice as well as method of delivery; and the role of more intensive glucose monitoring in comparison to conventional monitoring approaches.
[link url="http://cepac.icer-review.org/adaptations/diabetes/"]CEPAC review[/link]