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Type 2 diabetes is a chronic condition which can result in disability and early death.

General practitioners continue to provide most of the medical care to people with type 2 diabetes. The complexity of care for this common disease requires systematic care from the practice team and the timely referral to community and hospital based specialists.

The current guide, in its fourteenth edition, has an important role in providing a readable summary of current guidelines and recommendations from various sources on the management of type 2 diabetes in the general setting. We commend the guide and welcome your comments on its utility and improvements.

The aim of this booklet is to provide guidelines for management of type 2 diabetes. We hope that general practitioners will consult these guidelines in order to ensure a high standard of care for their patients.

Recent updates - December 2008

Recent Product Information changes impact on Chapter 6: Medication, page 37. General practitioners should note:

The glitazones (thiazolidinediones) are another class of oral hypoglycaemic agent and include pioglitazone and rosiglitazone. These agents are effective in lowering blood glucose by reducing insulin resistance.

Both glitazones can be used as dual therapy with metformin or sulphonylureas.

Pioglitazone can also be used in triple therapy with metformin and a sulphonylurea or in combination with insulin. Contraindications include moderate to severe cardiac failure.

Rosiglitazone is not indicated in triple therapy with metformin and a sulphonylurea or in combination with insulin. PBS reimbursement currently remains for patients stabilised on triple oral therapy. Contraindications include mild, moderate to severe, or any history of cardiac failure.

Rosiglitazone is not recommended in patients with known ischaemic heart disease, particularly in those taking nitrates. Refer to Product Information for more details.

Care is necessary in those with liver dysfunction and liver enzymes should be monitored with both agents.

Publication Date: 12 September 2008
Authorised By: publications