Diabetes is a chronic, progressive disease associated with significant morbidity and mortality. Fortunately, several long-term, prospective studies have demonstrated how proper medical management can significantly reduce the risks associated with diabetes. Based on these studies, the American Diabetes Association and American Association of Clinical Endocrinologists set forth standards and guidelines for the medical management of diabetes. The recommendations clearly outline a multifactorial plan for managing diabetes, but they do not provide specific recommendations for selection and titration of pharmacological treatment. Published reports suggest that specialists are adept at using complex drug regimens to reach the goals set forth in the guidelines, but primary care practitioners could benefit from treatment algorithms that guide the management of drug regimens for diabetes. This article briefly reviews the pharmacological management of type 2 diabetes and describes our experience developing a treatment algorithm for use within a managed care plan.
Mona Chitre, PharmD, CGP, is director of clinical services with FLRx Pharmacy Management, the Pharmacy Management Division of Excellus BlueCross BlueShield, and Susan Burke, RN, BSN, CDE, is manager of new product development and quality management at Excellus BlueCross BlueShield in Rochester, N.Y.
- American Diabetes Association