A recent consensus statement from the American Association of Clinical Endocrinology (AACE) and updated algorithms reiterate the significance of personalized care when treating type 2 diabetes. The AACE Comprehensive Type 2 Diabetes Management Algorithm emphasizes a complication-centric approach to determine first-line pharmacotherapy for individuals with diabetes. The algorithm includes two sections focusing on glucose-centric and complications-centric approaches to glycemic control for diabetes patients. The aim of the complications-centric approach is to personalize care as a wider range of medications to treat diabetes have become available, with an increased scope for individualization. The glycemic target for adults with complications should be an HbA1c of 6.5% or less, and for patients who do not reach their glycemic target within three months, their provider should adjust their medication dosage or add an additional treatment. The glucose-centric approach is prescribed when the patient has no CV complications, or their glycemic target was not met using the complications-centric approach. The glucose-centric algorithm includes lifestyle interventions, metformin where appropriate, and an individualized HbA1c target that is similar to the complications-centric approach. Providers treating adults at risk for severe hypoglycemia should receive basal insulin plus prandial insulin, a GLP-1, or GIP/GLP-1 therapy. The algorithm provides alternative therapies for adults in each category and recommends maximum tolerable dosage after three months, incorporating medical therapies and bariatric surgery for weight loss. The paper’s concluding section focuses on vaccination recommendations for people with type 2 diabetes, and people should receive vaccinations according to the CDC’s recommended immunization schedule, and the paper details each recommended vaccine.
