title: Therapeutic choices, and the nurse practitioner's role, in type 2 diabetes when metformin alone is no longer enough.
abstract: OBJECTIVE
  This article provides an overview of the currently available treatments for type 2 diabetes (T2D), outlining the most up to date information to assist nurse practitioners (NPs) to make informed prescribing decisions for T2D therapy once patients are no longer able to maintain blood glucose control using lifestyle modification and/or metformin therapy.
  
  
  METHODS
  Published guidelines for the management of T2D, review articles, primary manuscripts, and FDA prescribing information documents.
  
  
  CONCLUSIONS
  In the past, options for the treatment of T2D were limited. However, there is now an ever increasing number of available therapeutic choices for T2D, that, as well as glycemic control, offer significant additional benefits, particularly in terms of reducing hypoglycemic risk and weight gain. Consequently, these newer agents provide both patients and NPs with a much greater choice for ongoing therapy.
  
  
  CONCLUSIONS
  The differing benefits and risk profiles shown by the currently available antidiabetic treatments provide NPs with a unique opportunity to tailor treatment plans more closely to the requirements of each patient. This approach can ensure that the right drug reaches the right patient, which should in turn promote greater treatment compliance and improved outcomes, ultimately slowing disease progression.
authors.affiliation: Joslin Diabetes Center, Hospital of Central Connecticut, New Britain, Connecticut 06051, USA. ktierney@thocc.org
authors.forename: Kathryn
authors.initials: K
authors.lastname: Tierney
mesh_terms: D001786:Blood Glucose; D003657:Decision Making; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy* / Q000451:nursing; D004359:Drug Therapy, Combination; D006801:Humans; D007004:Hypoglycemic Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D007328:Insulin / Q000627:therapeutic use; D008687:Metformin / Q000008:administration & dosage / Q000627:therapeutic use*; D024802:Nurse's Role; D017410:Practice Guidelines as Topic; D045162:Thiazolidinediones / Q000627:therapeutic use
chemical_list: D001786:Blood Glucose; D007004:Hypoglycemic Agents; D007328:Insulin; D045162:Thiazolidinediones; D008687:Metformin