The American College of Physicians issued new guidelines for the treatment of Type 2 diabetes, recommending the use of GLP-1s and SGLT-2s alongside metformin. These medications have been shown to lower blood sugar levels and reduce the risk for various health complications, according to a study published in the Annals of Internal Medicine. The updated guidelines also recommend against the use of DPP-4 inhibitors alongside metformin.

The high costs of GLP-1s and SGLT-2s may be a significant barrier for patients in accessing treatment, with some GLP-1 medications already in shortage due to high demand. Drug shortages include Nordisk’s Wegovy and Eli Lilly’s Mounjaro and Zepbound. Manufacturers are working to increase supply, with Nordisk planning to gradually increase Wegovy supply throughout the year and Lilly opening a new manufacturing facility to help increase supply.

In 2021, 38.4 million Americans had diabetes, totaling 11.6% of the population, according to data from the American Diabetes Association. Another 97.6 million adults over the age of 18 had prediabetes. Research on the effects of GLP-1s on diabetes and weight loss has shown promising results, with participants experiencing a reduction in body weight and improvements in blood sugar levels.

The new guidelines are an update to the ACP’s 2017 recommendations, which focused on prescribing metformin as a primary treatment for Type 2 diabetes. The updated guidelines now recommend the use of GLP-1s and SGLT-2s alongside metformin to improve outcomes for patients with Type 2 diabetes. These medications have been shown to reduce the risk for various health complications, including major cardiovascular events and progression of chronic kidney disease.

The ongoing drug shortages of GLP-1s may be exacerbated by the new guidelines recommending their use alongside metformin. Manufacturers are working to increase supply of these medications to meet the demand from patients with diabetes. Despite the high costs of these medications, the ACP believes that the benefits of using GLP-1s and SGLT-2s for the treatment of Type 2 diabetes outweigh the potential barriers that patients may face in accessing these medications.

Overall, the new guidelines from the American College of Physicians represent a significant update in the treatment of Type 2 diabetes, recommending the use of GLP-1s and SGLT-2s alongside metformin to improve outcomes for patients with the condition. Despite challenges such as high costs and drug shortages, manufacturers are working to increase the supply of these medications to meet the needs of the growing number of Americans with diabetes. Further research and monitoring will be necessary to assess the long-term impact of these new guidelines on the management of Type 2 diabetes.

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