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Episode 8 - Changing the T2DM Treatment Paradigm
Peter Salgo, MD, notes that type 2 diabetes mellitus (T2DM) is associated with multiple metabolic defects. Traditional agents (eg, metformin, TZDs, and sulfonylureas) target insulin production and sensitivity. Agents with novel mechanisms of action are now available for T2DM, including agents that target the incretin system and agents that affect renal glucose handling. Characteristics of the various drugs may make them more suitable for individual patients.
Kari Uusinarkaus, MD, FAAFP, FNLA, comments that glucagon-like peptide agents are a good adjunct to metformin treatment because they reduce weight in patients while improving glycated hemoglobin levels. For this reason, this treatment option is often preferred by patients.
Yehuda Handelsman, MD, FACP, FACE, FNLA, describes safety considerations regarding the newer agents, including increases in risk for acute pancreatitis and heart disease, and use in patients with renal impairment.
Jeffrey D. Dunn, PharmD, MBA, discusses the costs of emerging diabetes treatment options. Dr Dunn and Maria Lopes, MD, MS, stress the importance of individualizing treatment and taking into account both efficacy and cost when treating patients with T2DM.
Managed Care Reflections: A Q&A With A. Mark Fendrick, MD, and Michael E. Chernew, PhD
December 2nd 2025To mark the 30th anniversary of The American Journal of Managed Care (AJMC), each issue in 2025 includes a special feature: reflections from a thought leader on what has changed—and what has not—over the past 3 decades and what’s next for managed care. The December issue features a conversation with AJMC Co–Editors in Chief A. Mark Fendrick, MD, director of the Center for Value-Based Insurance Design and a professor at the University of Michigan in Ann Arbor; and Michael E. Chernew, PhD, the Leonard D. Schaeffer Professor of Health Care Policy and the director of the Healthcare Markets and Regulation Lab at Harvard Medical School in Boston, Massachusetts.
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