Review Article

Expert Consensus on Telemedicine Management of Diabetes (2020 Edition)

Table 3

List of drugs recommended by the consensus for telemedicine management of diabetes.

Drug classificationType of actionDrug varietiesReason for recommendation

InjectionsShort-acting insulinRecombinant human insulin, biosynthetic human insulinCheap price
Insulin aspart, insulin lisproLow risk of hypoglycemia
Intermediate-acting insulinProtamine zinc recombinant human insulin, protamine biosynthetic human insulinCheap price
Premixed insulinProtamine recombinant human insulin (30/70), protamine biosynthetic human insulin (premixed 30R)Cheap price
Insulin aspart 30, protamine zinc recombinant insulin lispro (50R)Low risk of hypoglycemia
Long-acting insulin analogueInsulin glargineIncluded in the National Essential Medicines List of China
Insulin degludecA novel ultra-long-acting insulin with low risk of hypoglycemia [37].
GLP-1RALiraglutideIt is included in the National Essential Medicines List of China and is the GLP-1RA with the strongest evidence of cardiovascular benefit.
DulaglutideA weekly preparation, with evidence of cardiovascular and renal benefits [24, 32].

Oral antihyperglycemic agentsBiguanidesMetformin
SulfonylureasGlimepirideA new generation of sulfonylureas with low risk of hypoglycemia; research has shown its cardiovascular safety similar to that of DPP-4i [38].
Gliclazide sustained-release tabletsADVANCE research suggests that gliclazide sustained-release tablets may have a renal protection; there is a low risk of hypoglycemia.
GlinidesRepaglinideIt can be used throughout the course of CKD, with no need to adjust the dose.
α-Glucosidase inhibitorsAcarboseWidely used in the Chinese population [36], with cheap price.
DPP-4iLinagliptinIt can be used throughout the course of impaired hepatic and renal function, with no need to adjust the dose.
AlogliptinMeta-analysis reveals its good effect in Asian populations [39]; it has high affinity for DPP-4 and high bioavailability.
SGLT-2iEmpagliflozinIt has definite benefits for ASCVD, HF, and CKD [22], and nowadays, it is the only marketed drug to reduce the risk of death from CVD.
DapagliflozinIt is included in the National Essential Medicines List of China. This drug has definite benefits for both HF and CKD [21], but there is insufficient evidence to determine whether it has benefit for ASCVD.
ThiazolidinedionesPioglitazonePROACTIVE has found that it can reduce the risk of stroke recurrence [29].

GLP-1RA: glucagon-like peptide-1 receptor agonist; SGLT-2i: sodium-glucose cotransporter-2 inhibitor; DPP-4i: dipeptidyl peptidase-4 inhibitor; T2DM: type 2 diabetes mellitus; ASCVD: atherosclerotic cardiovascular disease; HF: heart failure; CKD: chronic kidney disease.