The American Diabetes Association (ada) and the European Association for the Study of Diabetes (EASD), in a new consensus statement recommends that newly-diagnosed patients with diabetes should be treated with metformin (Glucophage®) in conjunction with lifestyle modification (unless metformin is contraindicated) and that the initiation of metformin should no longer be delayed until lifestyle modification (weight loss and increased activity) fails to adequately control glycaemia.

These new recommendations are contradicting the traditional guidelines where lifestyle modification was the first step in intervention to reduce glycaemia.

However, currently, the ADA/EASD expert panel has recognised that lifestyle modification alone often fails to achieve or maintain metabolic goals and so most patients will also require effective treatment with metformin (Glucophage®). Therefore it will be more beneficial to diabetic patients if metformin (Glucophage) is administered at once after diagnosis.

According to Dr Clifford Bailey, Professor of Clinical Science at Aston University, Birmingham, UK, and a member of the EASD committee that reviewed the new treatment algorithm:

"Metformin is widely available and efficacious in long-term glycaemic control. The recommendation of metformin at diagnosis of type 2 diabetes is not a major variation from many other treatment algorithms, but is noteworthy in that it appears for the first time in an international consensus guideline."

The ADA/EASD expert panel recommends that following initiation of treatment, metformin (Glucophage) should be titrated to the maximum effective and tolerated dose over one to two months. Only after which should another agent be added if required to achieve glycaemic goals.

Read Bristol-Myers Squibb's full prescribing information for Glucophage® (a pdf file).

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