Background The range of oral hypoglycaemic agents (OHAs) has increased from one insulin sensitiser
(metformin) and one class of insulin secretagogues (sulphonylureas) with the addition
of further class of insulin secretagogues (glitinides), a further class of insulin sensitisers
(glitazones) and two new classes: an alpha glycosidase inhibitor and glucagon-like
peptide agents. Recent data has influenced the recommended sequence and usage of
OHAs and glycaemic targets.
Objective This article reviews the recent evidence in type 2 diabetes about the pros and cons of
oral hypoglycaemic agents and the benefits and costs of intensive glycaemic control. It
suggests a stepwise approach to glycaemic control with OHAs according to the evidence
base currently available.
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