IDF Treatment Algorithm for People with Type 2 Diabetes

Lifestyle measures

Then, at each step, if not to target (generally HbA1c ‹7.0 %)

Consider first line

Sulfonylurea
Metformin or
α - Glucosidase inhibitor

Consider second line

α - Glucosidase inhibitor or
Metformin
Sulfonylurea or DPP-4 inhibitor or
(if not first line)
Thiazolidinedione

Consider third line

Basal insulin α - Glucosidase inhibitor or
or or DPP-4 inhibitor or or GLP-1 agonist
Pre-mix insulin Thiazolidinedione

Consider fourth line

Basal + Basal insulin, or = usual approach
meal-time < Pre-mix insulin
insulin (later basal + meal-time) = alternative approach