The American Diabetic Association has dropped its previous recommendations about the newer and much more expensive diabetic meds. Most patients should be managed by lifestyle changes, metformin, sulfonylureas (like Glucotrol) and insulin if needed. The newer drugs like Avandia, Actose and Byetta are not as effective and the former increases the risk of heart disease. Precose, Prandin, Januvia, and Sumlin are usually not recommended because of their cost and they are no more effective than the standard drugs.
See Prescriber’s Letter (subscription required) 12/08, p. 68.
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