Consensus 2021 for medical management of type 2 diabetes from the diabetes, obesity, and nutrition working group of the Spanish Society of Internal Medicine

Type 2 diabetes (T2D) is a major health concern due to its high prevalence, severe morbidity, and elevated mortality. Medical antidiabetic treatment is constantly changing and becoming more complex. Many national and international societies have published recommendations for the medical treatment of T2D focused on patients’ clinical situations instead of glycemic control. However, most consensus documents offer such comprehensive information that it can be difficult to apply and effectively put into practice. This document contains the necessary 2021 update of the consensus statement about recommendations for the medical management of T2D from the Diabetes, Obesity, and Nutrition Working Group of the Spanish Society of Internal Medicine. The aim of this consensus document is to facilitate therapeutic decision-making to improve diabetes patient care. By focusing on clinical conditions such as cardiovascular risk, heart failure, diabetic kidney disease, obesity and overweight, the elderly population, risk of hypoglycemia, and history of diabetes of more than 10 years, the consensus recommends selecting antidiabetic drugs according to the best available evidence. The document prioritizes the use of glucagon-like peptide-1 receptor agonists and sodium-glucose contransporter-2 inhibitors due to their additional cardiovascular and renal benefits beyond glycemic control.