New guidelines propose individualized drug selection and early combination therapies for managing type 2 diabetes.
The 2025 Clinical Practice Guidelines for Diabetes by the Korean Diabetes Association represent a major shift toward individualized and practical pharmacological strategies. Moving beyond glycemic thresholds, the guidelines emphasize person-centered care that accounts for life expectancy, comorbidities, treatment acceptability, and social determinants of health. Insulin initiation is now recommended for patients with hypercatabolic symptoms regardless of HbA1c levels. The algorithm promotes early use of combination therapies, including dual, triple, or injectable agents when appropriate. Metformin is no longer the sole first-line agent; instead, drug selection is guided by shared decision-making and clinical context. Oral quadruple therapy is newly recognized as a feasible alternative in patients unsuited for injectable treatment. Furthermore, drug choices are aligned with specific comorbidities, such as heart failure, chronic kidney disease, ischemic stroke, and obesity-related metabolic dysfunction. These updates aim to improve early glycemic control, reduce therapeutic inertia, and provide tailored options for the diverse clinical settings in Korea. Overall, the 2025 Clinical Practice Guidelines for Diabetes mark a comprehensive advancement in the treatment of type 2 diabetes.
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Jong Han Choi (2025) studied this question.
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