Pioglitazone, SU, and insulin are now third- and fourth-line agents due to the associated weight gain, risk of hypoglycaemia, and need for SMBG with insulin and SU.

Formal Recommendations

Recommendation & Evidence

Recommendation Strength-

Evidence Level-

Recommendation direction

People with type 2 diabetes requiring third- or fourth-line therapy

Reserve pioglitazone, sulfonylureas, and insulin for third- or fourth-line use because of weight gain, hypoglycemia, and monitoring burden

Use as earlier-line therapy

Not reported

Evidence No.-

Evidence-

Evidence Level-

Recommendation Strength-

Statement TypeFormal Recommendations

Guideline NameSamoa MOH National Diabetes Guidelines

Guideline No.2-2024-035E

AuthorAlec Ekeroma

Guideline TypeGuideline

Year2024

OrganizationMinistry of Health Samoa

RegionOceania

CountrySamoa

Conflict of InterestNo

DOI无

Target Population所有糖尿病患者（包括1型糖尿病、2型糖尿病、妊娠期糖尿病、儿童及青少年），特别是萨摩亚及太平洋人群，包括高危人群（超重/肥胖、有家族史、既往糖尿病史等）

Journal无

Recommendation Strength MethodologyNone

Evidence Level MethodologyNone

Living GuidelineNo

Rapid AdviceNo

UpdatedNo

Recommendation Count0

Reference Count50

Guideline TopicComprehensive

CategoriesPharmacologic Glycemic Management of Type 2 Diabetes

Created At2026-10-21 14:39:47

Updated At2026-10-21 14:39:47