It was in 2012, the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD) first published a position statement on the management of hyperglycaemia in patients with type 2 diabetes which described the need to individualise both treatment targets and treatment strategies, with an emphasis on patient-centred care and shared decision-making, and this continues in the current position, although there are now more head-to-head trials that show slight variance between agents with regard to glucose-lowering effects.

In 2015 Position statement revisions were made as per the changing evidence base. Efficacy, cost considerations, insulin initiation guidelines, incorporating SGLT2 inhibitors etc. are the notable additions. SGLT2 inhibitors are approved for monotherapy but are mainly used in combination with metformin and/or other agents. Given their efficacy, SGLT2 inhibitors are reasonable options as second line or third line agents.

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