GLYCEMIC CON TR OL A LG ORI T H M

LIFESTYLE THERAPY
(Including Medically Assisted Weight Loss)

Entry A1C < 7.5% Entry A1C ≥ 7.5% Entry A1C > 9.0%

M O NOT HE R APY* SYM PTOM S

DUA L T H ER A PY *
Metformin NO YE S
GLP-1 RA TR I P L E TH E R A PY *
GLP-1 RA
SGLT-2i DUAL INSULIN
SGLT-2i GLP-1 RA
Therapy ±
DPP-4i SGLT-2i Other
DPP-4i

TZD
MET TZD MET TZD
OR Agents
or other or other
TRIPLE
1st-line Basal Insulin 1st-line Basal insulin
AGi Therapy

+
agent agent +
Colesevelam 2nd-line DPP-4i
SU/GLN

+
agent
Bromocriptine QR Colesevelam
AGi Bromocriptine QR
A DD OR INTENSIFY
SU/GLN AGi INSULIN
If not at goal in 3 months
Refer to Insulin Algorithm
SU/GLN
proceed to Dual Therapy If not at goal
in 3 months
proceed to LEGEND
Triple Therapy If not at goal in
3 months proceed Few adverse events and/or
to or intensify possible benefits
insulin therapy
* Order of medications represents a suggested hierarchy of usage; Use with caution
length of line reflects strength of recommendation

P R O G R E S S I O N O F D I S E A S E
COPYRIGHT © 2017 AACE MAY NOT BE REPRODUCED IN ANY FORM WITHOUT EXPRESS WRITTEN PERMISSION FROM AACE. DOI 10.4158/EP161682.CS