AACE Clinical Guidelines Flashcards
Is AACE used for loose or strict targets?
Strict
AACE A1C goal
6.5%
AACE FBG goal
<110 mg/dl
AACE PPG goal
<140 mg/dl
When do you use the AACE guidelines?
Patients <65 without a clinical ASCVD event
In the AACE guidelines, if a patient has established high-risk ASCVD and/or CKD, what therapies do you recommend?
SGLT2i and/or a long-acting GLP-1RA
Treatment for entry-level A1C of <7.5%
MONOTHERAPY!
Metformin GLP-1RA SGLT2i DPP4i TZD AGi SU/GLN
Treatment for entry-level A1C of ≥7.5-9.0%
DUAL OR TRIPLE THERAPY!
Drugs in dual therapy
Metformin and one of these:
GLP-1RA SGLT2i DPP4i TZD SU/GLN Basal insulin Colesevelam Bromocriptine QR AGi
(Patients starting out on monotherapy can move here after 3 months if not at goal)
Drugs in triple therapy
Metformin and two of these:
GLP-1RA SGLT2i TZD SU/GLN Basal insulin DPP4i Colesevelam Bromocriptine QR AGi
(Patients on dual therapy can move here in 3 months if not at goal)
Entry-level A1C of 9.0% with no symptoms
Start dual or triple therapy
Entry-level A1C of 9.0% with symptoms
Insulin +/- other agents
Patients on triple therapy can also move here in 3 months if not at goal
AACE guidelines on starting basal insulin when A1C is <8.0%
TDD is 0.1-0.2 units/kg
AACE guidelines on starting basal insulin when A1C is >8.0%
TDD is 0.2-0.3 units/kg
When do you add prandial insulin?
Consider adding a GLP-1RA, SGLT2i, or DPP4i first before prandial insulin
