The revisions to the diabetes treatment algorithm, first published in 2006,provide guidance to health care providers for treating type 2 diabetes,taking into account new medications that have come on the market and themost current scientific data regarding previously recommended drugs.

The algorithm describes a stepped-care approach to treat the elevatedlevels of blood glucose and A1C, a measure of average glucose levels duringthe previous two to three months that characterize diabetes. The consensusstatement authors again suggest lifestyle changes and metformin as theinitial treatment to help people newly diagnosed with type 2 diabetesachieve A1C goals. The lifestyle intervention and metformin are usuallycontinued throughout the treatment course. However, if glucose/glycemicgoals are not met, or not maintained over time, the algorithm progresses toStep 2 and provides two choices. The first choice, which is preferred andwell validated, calls for the addition of basal insulin or a sulfonylureato lifestyle changes and metformin. The second choice includes theaddition of pioglitazone or a GLP-1 agonist to lifestyle changes andmetformin. If the Step 2 choices do not maintain A1C goals, the panelsuggests initiation of basal insulin, if not already started, and thentransition to intensive insulin (Step 3), if needed. As in the originalalgorithm, all of the transitions in therapy usually occur at 3-monthintervals, aiming for rapid achievement and continuous maintenance ofnear-normal glucose and A1C levels.

"Excellent glycemic control is critical to prevent the long-termcomplications associated with diabetes, which can lead to loss of vision,kidney failure, and amputations," said Dr. David M. Nathan, Chair of thePanel. "After much deliberation, we intentionally chose therapies wehighly recommend as safe, effective, and that have much evidence supportingtheir use. The second tier drugs are valuable if hypoglycemia is a majorconcern, but the use of these drugs is less validated."

For interviews with Dr. Nathan, please e-mail him at dnathan@partners.org.

Prof. Ele Ferrannini, Past President of EASD, said, "This joint EASD/ADAstatement on the treatment of type 2 diabetes is an effort to represent thelatest scientific evidence relevant to the use of blood glucose loweringagents in the hope of providing comprehensive guidance to clinicians."

For interviews with Prof. Ferrannini, please e-mail ferranni@ifc.cnr.it.

Diabetes Care, published by the American Diabetes Association, is theleading peer-reviewed journal of clinical research into one of the nation'sleading causes of death by disease. Diabetes also is a leading cause ofheartdisease and stroke, as well as the leading cause of adult blindness, kidneyfailure, and non-traumatic amputations.

The American Diabetes Association is leading the fight against the deadlyconsequences of diabetes and fighting for those affected by diabetes. TheAssociation funds research to prevent, cure and manage diabetes; deliversservices to hundreds of communities; provides objective and credibleinformation; and gives voice to those denied their rights because ofdiabetes. Founded in 1940, our mission is to prevent and cure diabetes andto improve the lives of all people affected by diabetes. For moreinformation, please call the American Diabetes Association at1-800-DIABETES (1-800-342-2383) or visit www.diabetes.org. Informationfrom both these sources is available in English and Spanish.

Diabetologia, the official journal of EASD, is the leading publication inEurope for clinical and basic diabetes research and conveys new informationand insights into the condition, ranging from basic science to clinicalapplications.

The EASD was founded in 1965 and itsannual diabetes meeting brings together the largest international audienceof diabetologists. In 2008, the EASD Annual Meeting was attended by over18,000 participants from 124 countries. EASD generously funds travelgrants to young presenters from all over the world, numerous postgraduateactivities in Europe and beyond and works closely with European researchinstitutions. EASD has never been restricted by the borders of Europe andits membership is open to all nationalities. The European Foundation forthe Study of Diabetes, which was founded by the EASD, has committed over 55million Euros to diabetes research and cooperates with partners fromindustry and other with non-profit organisations.

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Contact:Dayle KernADA(703) 549-1500 ext. 2290Dr. Monika GrüsserEASD+49-211-758469-0