Second steps for type 2 diabetes

If the glycaemic targets are still not met, prescribers have a wide choice of drugs they can add to the regimen.

The traditional approach is to add a sulfonylurea, and there is a lot of experience with these drugs.

However, Therapeutic Guidelines: Endocrinology says that insulin or one of the drugs acting on the incretin pathway can also be considered.

Dipeptidyl peptidase-4 (DPP-4) inhibitors stop the breakdown of the incretins.

Therapeutic Guidelines: Endocrinology