Figure. Algorithm for the Metabolic Management of Type 2 Diabetes.

Reinforce lifestyle intervention at every visit.

*Check HbA_1c every 3 months until <7% and then at least every 6 months.

†Although 3 oral agents can be used, initiation and intensification of insulin therapy is preferred based on effectiveness and expense.

Hb indicates hemoglobin.

Reprinted with permission from Nathan DM, Buse JB, Davidson MB, et al. Management of hyperglycemia in type 2 diabetes: a consensus algorithm for the initiation and adjustment of therapy. Diabetes Care. 2006;29:1963–1972.