此次治療指引為了反應最近的心臟血管結果試驗(CVOT) 數據研究結果，增加了針對成 人第二型糖尿病抗高血糖藥物治療的新建議，指出動脈粥樣硬化性心臟血管疾病(ASCVD) 患 者應該從生活方式管理和metformin 使用開始，並在考慮藥物的特異性和患者因素後，隨後 加入一種被證明可以減少主要不良心臟血管事件和/ 或心臟血管死亡率的藥物。並更新了高 血糖治療的流程圖( 圖一)，以納入新的ASCVD 建議。新表格( 表一) 總結了抗高血糖藥物 的特異性和患者因素。圖一和表一指導了抗高血糖藥物的選擇，以作為患者和醫療提供者共 享決策的一部分。表二有進行修改，重點在關注美國目前可以使用的降血糖藥物的藥理學和 作用機轉。

New recommendations for antihyperglycemic therapy for adults with type 2 diabetes have been added to reflect recent cardiovascular outcomes trial (CVOT) data, indicating that people with atherosclerotic cardiovascular disease (ASCVD) should begin with lifestyle management and metformin and subsequently incorporate an agent proven to reduce major adverse cardiovascular events and/or cardiovascular mortality after considering drugspecific and patient factors. The algorithm for antihyperglycemic treatment (Fig.1) was updated to incorporate the new ASCVD recommendation. A new table was added (Table 1) to summarize drug-specific and patient factors of antihyperglycemic agents. Fig. 1 and Table 1 are meant to be used together to guide the choice of antihyperglycemic agents as part of patient–provider shared decision-making. Table 2 was modified to focus on the pharmacology and mechanisms of available glucose-lowering medicines in the U.S. (J Intern Med Taiwan 2018; 29: 92-106)