ACE Clinical Guidances (ACGs)

ACE Clinical Guidances (ACGs)

ACGs* provide concise, evidence-based recommendations to inform specific areas of clinical practice and serve as a common starting point nationally for clinical decision-making. ACGs are underpinned by a wide array of considerations contextualised to Singapore, based on best available evidence at the time of development. Each ACG is developed in collaboration with a multidisciplinary group of local experts representing relevant specialties and practice settings. ACGs are not exhaustive of the subject matter and do not replace clinical judgement. 

Registered doctors, pharmacists and nurses may claim 1 Continuing Medical Education (CME)/Continuing Professional Education (CPE) point under category 3A/ Category V-B for reading each ACG.

*previously known as Appropriate Care Guides
Published on 17 May 2023
Last Updated on 17 May 2023
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This ACE Clinical Guidance (ACG) focuses on optimising management of type 2 diabetes mellitus (T2DM) by personalising selection of non-insulin T2DM medications based on patient comorbidities and risk factors, in particular cardiovascular and renal factors.

This ACG replaces the 2017 ACG “Oral glucose-lowering agents in type 2 diabetes mellitus – an update”.  

Download the PDF below to access the ACG.
Registered doctors, pharmacists and nurses may claim 1 Continuing Medical Education (CME)/Continuing Professional Education (CPE) point under category 3A/ category V-B for reading each ACG.

 

ACG Recommendations
1.Assess the patient’s glycaemic control and risk of adverse cardiorenal outcomes.
2.Select and adjust T2DM medication(s) based on the patient’s glycaemic control and their risk of adverse cardiorenal outcomes.
3.Consider metformin as first-line T2DM medication.
4.Consider prescribing an SGLT2 inhibitor or GLP-1 RA for patients with T2DM who need to reduce their risk of adverse cardiorenal outcomes.
5.Adopt a patient-centred approach to make shared decisions on T2DM management.
6.Educate patients with T2DM on sustained lifestyle intervention, medication adherence, and regular review.
7.Review all patients with T2DM regularly, including treatment response and complication screening.
T2DM – personalising management T2DM – personalising management references T2DM – personalising management useful resources

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