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Management Of Hyperglycemia In Type 2 Diabetes 2015

Management Of Hyperglycemia In Type 2 Diabetes, 2015: A Patient-centered Approach: Update To A Position Statement Of The American Diabetes Association And The European Association For The Study Of Diabetes

Management Of Hyperglycemia In Type 2 Diabetes, 2015: A Patient-centered Approach: Update To A Position Statement Of The American Diabetes Association And The European Association For The Study Of Diabetes

Management of Hyperglycemia in Type 2 Diabetes, 2015: A Patient-Centered Approach: Update to a Position Statement of the American Diabetes Association and the European Association for the Study of Diabetes Silvio E. Inzucchi - Section of Endocrinology, Yale University School of Medicine, Yale-New Haven Hospital, New Haven, CT Richard M. Bergenstal - Park Nicollet Health Services John B. Buse - University of North Carolina at Chapel Hill Apostolos Tsapas - Aristotle University of Thessaloniki Richard Wender - American Cancer Society, Thomas Jefferson University David R. Matthews - NIHR Oxford Musculoskeletal Biomedical Research Unit, Churchill Hospital, University of Oxford 2018 Digital Science & Research Solutions, Inc. All Rights Reserved | About us Privacy policy Legal terms VPAT Citation Count is the number of times that this paper has been cited by other published papers in the database. The Altmetric Attention Score is a weighted count of all of the online attention Altmetric have found for an individual research output. This includes mentions in public policy documents and references in Wikipedia, the mainstream news, social networks, blogs and more. More detail on the weightings of each source and how they contribute to the attention score is available here . The Relative Citation Ratio (RCR) indicates the relative citation performance of an article when comparing its citation rate to that of other articles in its area of research. A value of more than 1.0 shows a citation rate above average. The articles area of research is defined by the articles that have been cited alongside it. The RCR is normalized to 1.0 for all articles. The Field Citation Ratio (FCR) is an article-level metric that indicates the relative citation performance of an article, when compared Continue reading >>

Ada/easd Guidelines Hyperglycemia Management In Type 2 Diabetes | Ndei

Ada/easd Guidelines Hyperglycemia Management In Type 2 Diabetes | Ndei

If A1C target is not achieved after 3 months of dual therapy, proceed to Triple Therapy If A1C target is not achieved after 3 months of triple therapy and patient (1) is on oral combination, move to injectable; (2) on GLP-1, add basal insulin; or (3) on optimally titrated basal insulin, add GLP-1 or mealtime insulin. Refractory patients: consider adding TZD or SGLT2. Basal insulin + mealtime insulin or GLP-1 If not controlled after FBG target is reached or if dose >0.5 U/kg/d Add 1 rapid insulin injection before largest meal 4 U, 0.1 U/kg, or 10% basal dose. If A1C <8%, consider decreasing basal dose by same amount Increase dose by 1-2U or 10-15% once to twice weekly until SMBG target is reached Decrease corresponding dose by 2-4U or 10-20% for hypoglycemia Divide current basal dose into 2/3 AM, 1/3 PM, or 1/2 AM, 1/2 PM Increase dose by 1-2U or 10-15% once to twice weekly to reach SMBG target Decrease corresponding dose by 2-4U or 10-20% for hypoglycemia Add 2 rapid insulin injections before meals: basal-bolus 4 U, 0.1 U/kg, or 10% basal dose/meal. If A1C <8%, consider decreasing basal by same amount Increase dose by 1-2U or 10-15% once to twice weekly until SMBG target is reached Decrease corresponding dose by 2-4U or 10-20% for hypoglycemia Continue reading >>

Exchangecme :: Resources

Exchangecme :: Resources

Standards of medical care in diabetes2015. American Diabetes Association. Diabetes Care. 2015;38(suppl 1):S1-S94. The ADAs Standards of Care provide clinicians, patients, researchers, payers, and other interested individuals with the components of good diabetes management, general treatment goals, and tools to evaluate the quality of care. Importantly, these recommendations should be adjusted based on individual preferences, comorbidities, and other patient-related factors. American Association of Clinical Endocrinologists and American College of EndocrinologyClinical practice guidelines for developing a diabetes mellitus comprehensive care plan2015. Handelsman Y, Bloomgarden ZT, Grunberger G, et al.Endocr Pract. 2015;21(suppl 1):1-87. These 2015 clinical practice guidelines provide a practical guide for comprehensive care that incorporates an integrated consideration of microvascular and macrovascular riskincluding such cardiovascular risk factors as lipids, hypertension, and coagulationrather than focusing only on glycemic control. The guidelines emphasize individualized targets for weight loss, glucose, lipid, and blood pressure, and contain updated information on hypertension management, nephropathy management, hypoglycemia, and antihyperglycemic therapy. AACE/ACE comprehensive diabetes management algorithm 2015. Garber AJ, Abrahamson MJ, Barzilay JI, et al.Endocr Pract. 2015;21(4):438-447. This algorithm from the AACE addresses evaluating the whole patient, potential risks and complications, and evidence-based treatment approaches for diabetes. The document contains sections on obesity, prediabetes, hyperglycemia therapy (lifestyle modifications, pharmacotherapy, and insulin), hypertension management, hyperlipidemia treatment, and other risk-reduction strategies. Continue reading >>

Dailyrounds Cme On Management Of Persistent Hyperglycemia In Type 2 Diabetes Mellitus.| Dailyrounds

Dailyrounds Cme On Management Of Persistent Hyperglycemia In Type 2 Diabetes Mellitus.| Dailyrounds

DailyRounds CME on Management of Persistent Hyperglycemia in Type 2 Diabetes Mellitus. DailyRounds CME on Management of Persistent Hyperglycemia in Type 2 Diabetes Mellitus. Scope:This article's main focus is the Management of Persistent Hyperglycemia in Type 2 Diabetes Mellitus. Initial Management Of Diabetes Mellitus is discussed separately. Treatment for hyperglycemia that fails to respond to initial monotherapy and long-term pharmacologic therapy in type 2 diabetes is discussed here. Decreased compliance with diet, exercise, or the medical regimen, or weight gain. An intercurrent illness or the ingestion of drugs. Progression of the underlying disease process. Presence of latent autoimmune diabetes in adults(LADA). Failure of health-care provider to initiate or intensify therapy when therapeutic goals are not reached. Therapeutic Approach to Persistent Hyperglycemia The American Diabetes Association Diabetes Care 2017 suggests the following approach for management of persistent hyperglycemia.[1] If noninsulin monotherapy at maximum tolerated dose does not achieve or maintain the A1C target after 3 months,add A glucagon-like peptide 1 receptor agonist, or If A1C target is still not achieved after 3 months of dual therapy, proceed to three-drug combination. Again, if A1C target is not achieved after 3 months of triple therapy, proceed to combination injectable therapy Failure of Metformin monotherapy (ie, If the A1C target is not achieved with Metformin after approximately 3 months). Studies suggests that each new class of noninsulin agents added to initial therapy generally lowers A1C approximately 0.91.1% [2] Consider a combination of Metformin and one of the six available treatment options: Sulfonylurea, Thiazolidinedione, DPP-4 inhibitor, SGLT2 inhibitor, GLP-1 r Continue reading >>

Pharmacologic Therapy For Type 2 Diabetes: Synopsis Of The 2017 American Diabetes Association Standards Of Medical Care In Diabetes Free

Pharmacologic Therapy For Type 2 Diabetes: Synopsis Of The 2017 American Diabetes Association Standards Of Medical Care In Diabetes Free

Abstract Description: The American Diabetes Association (ADA) annually updates the Standards of Medical Care in Diabetes to provide clinicians, patients, researchers, payers, and other interested parties with evidence-based recommendations for the diagnosis and management of patients with diabetes. Methods: For the 2017 Standards, the ADA Professional Practice Committee updated previous MEDLINE searches performed from 1 January 2016 to November 2016 to add, clarify, or revise recommendations based on new evidence. The committee rates the recommendations as A, B, or C, depending on the quality of evidence, or E for expert consensus or clinical experience. The Standards were reviewed and approved by the Executive Committee of the ADA Board of Directors, which includes health care professionals, scientists, and laypersons. Feedback from the larger clinical community informed revisions. Recommendations: This synopsis focuses on recommendations from the 2017 Standards about pharmacologic approaches to glycemic treatment of type 2 diabetes. The American Diabetes Association (ADA) first released its Standards of Medical Care in Diabetes for health professionals in 1989. These practice guidelines provide an extensive set of evidence-based recommendations that are updated annually for the diagnosis and management of patients with diabetes. The 2017 Standards cover all aspects of patient care (1); this guideline synopsis focuses on pharmacologic approaches for patients with type 2 diabetes. Pharmacologic Therapy for Type 2 Diabetes: Recommendations Initial Treatment Approach: Metformin Assessing Response and Deciding to Intensify Therapy Recent Evidence From Cardiovascular Outcomes Trials Recent Warnings About Pharmacotherapies Insulin Therapy Continue reading >>

Management Of Hyperglycaemia In Type 2 Diabetes, 2015: A Patient-centred Approach. Update To A Position Statement Of The American Diabetes Association And The European Association For The Study Of Diabetes

Management Of Hyperglycaemia In Type 2 Diabetes, 2015: A Patient-centred Approach. Update To A Position Statement Of The American Diabetes Association And The European Association For The Study Of Diabetes

, Volume 58, Issue3 , pp 429442 | Cite as Management of hyperglycaemia in type 2 diabetes, 2015: a patient-centred approach. Update to a Position Statement of the American Diabetes Association and the European Association for the Study of Diabetes GuidelinesInsulinOral agentsTherapyType 2 diabetes Michaela Diamant is credited posthumously. Her experience, wisdom and wit were key factors in the creation of the original 2012 position statement; they continued to resonate with us during the writing of this update. S. E. Inzucchi and D. R. Matthews were co-chairs for the Position Statement Writing Group. R. M. Bergenstal, J. B. Buse, A. L. Peters and R. Wender were the Writing Group for the American Diabetes Association. M. Diamant, E. Ferrannini, M. Nauck and A. Tsapas were the Writing Group for the European Association for the Study of Diabetes. Simultaneous publication: This article is being simultaneously published in Diabetes Care and Diabetologia by the American Diabetes Association and the European Association for the Study of Diabetes. Copyright 2014 by the American Diabetes Association and Springer-Verlag. Copying with attribution allowed for any non-commercial use of the work. The online version of this article (doi: 10.1007/s00125-014-3460-0 ) contains an ESM slide set for this paper and an abridged version, which is available to authorised users. In 2012, the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD) published a position statement on the management of hyperglycaemia in patients with type 2 diabetes [ 1 , 2 ]. This was needed because of an increasing array of anti-hyperglycaemic drugs and growing uncertainty regarding their proper selection and sequence. Because of a paucity of comparative effectiveness res Continue reading >>

An Update On Hyperglycemia In Type 2 Diabetes

An Update On Hyperglycemia In Type 2 Diabetes

An Update on Hyperglycemia in Type 2 Diabetes Clinical Director, Section of Endocrinology Director, Yale Affiliated Hospitals Program Silvio E. Inzucchi, MD, has indicated to Physicians Weekly that he has worked as a consultant for Merck, Boehringer Ingelheim, sanofi, and Novo Nordisk and as a paid speaker for AstraZeneca. He has also received grants/research aid from Takeda for study drug and placebo only. Clinical Director, Section of Endocrinology Director, Yale Affiliated Hospitals Program Silvio E. Inzucchi, MD, has indicated to Physicians Weekly that he has worked as a consultant for Merck, Boehringer Ingelheim, sanofi, and Novo Nordisk and as a paid speaker for AstraZeneca. He has also received grants/research aid from Takeda for study drug and placebo only. The American Diabetes Association and European Association for the Study of Diabetes have updated recommendations for managing hyperglycemia in type 2 diabetes. Patient-centered care and shared decision making continue to be important focus areas for clinicians. In 2012, the American Diabetes Association and the European Association for the Study of Diabetes published a position statement on the management of hyperglycemia in patients with type 2 diabetes. This was needed because of an increasing array of anti-hyperglycemic drugs and growing uncertainty regarding their proper selection and sequence, says Silvio E. Inzucchi, MD. However, the 2012 document was less prescriptive than prior consensus reports because of a paucity of comparative effectiveness research on long-term treatment outcomes with many of these medications. Recently, the American Diabetes Association and the European Association for the Study of Diabetes requested an update to the position statement that incorporates new data from recent cl Continue reading >>

Demystifying

Demystifying "patient-centered" Care In Type 2 Diabetes: The Role Of Systematic Measurement

Demystifying "Patient-Centered" Care in Type 2 Diabetes: The Role of Systematic Measurement Evidence-Based Diabetes Management > March 2016 Published on: March 18, 2016 Demystifying "Patient-Centered" Care in Type 2 Diabetes: The Role of Systematic Measurement Questionnaires are noninvasive, inexpensive measures that can identify key elements of the patient perspective that are important for the achievement of better outcomes in diabetes care. Questionnaires are noninvasive, inexpensive measures that can identify key elements of the patient perspective that are important for the achievement of better outcomes in diabetes care. Over the last several decades, tremendous advancements have been made in understanding the microvascular and macrovascular pathophysiology of type 2 diabetes (T2D) and in understanding the roles of a healthy diet, physical activity, and pharmacotherapies in reducing morbidity and mortality associated with uncontrolled plasma glucose levels.1 Major public health initiatives have been implemented to support the prevention and management of T2D, and recent guidelines from the American Diabetes Association (ADA), the American Association of Diabetes Educators, and the Academy of Nutrition and Dietetics outline diabetes self-management education and support strategies that healthcare providers and accountable care organizations (ACOs) can use to promote self-care behaviors.2 These self-care behaviors include healthy eating, physical activity, daily monitoring activities, medication adherence, problem-solving skills, risk reduction strategies, and healthy coping strategies.2 These guidelines, along with the joint ADA/ European Association for the Study of Diabetes position statement on the treatment of T2D emphasize the importance of considering indivi Continue reading >>

Management Of Hyperglycemia In Type 2 Diabetes, 2015: A Patient-centeredapproach: Update To A Position Statement Of The American Diabetes Association Andthe European Association For The Study Of Diabetes.

Management Of Hyperglycemia In Type 2 Diabetes, 2015: A Patient-centeredapproach: Update To A Position Statement Of The American Diabetes Association Andthe European Association For The Study Of Diabetes.

1. Diabetes Care. 2015 Jan;38(1):140-9. doi: 10.2337/dc14-2441. Management of hyperglycemia in type 2 diabetes, 2015: a patient-centeredapproach: update to a position statement of the American Diabetes Association andthe European Association for the Study of Diabetes. Inzucchi SE(1), Bergenstal RM(2), Buse JB(3), Diamant M(4), Ferrannini E(5),Nauck M(6), Peters AL(7), Tsapas A(8), Wender R(9), Matthews DR(10). (1)Section of Endocrinology, Yale University School of Medicine, Yale-New Haven Hospital, New Haven, CT [email protected] (2)International Diabetes Center at Park Nicollet, Minneapolis, MN. (3)Division of Endocrinology, University of North Carolina School of Medicine, Chapel Hill, NC. (4)Diabetes Center/Department of Internal Medicine, VU University Medical Center, Amsterdam, the Netherlands. (5)Department of Medicine, University of Pisa School of Medicine, Pisa, Italy. (6)Diabeteszentrum Bad Lauterberg, Bad Lauterberg im Harz, Germany. (7)Division of Endocrinology, Keck School of Medicine of the University of Southern California, Los Angeles, CA. (8)Second Medical Department, Aristotle University Thessaloniki, Thessaloniki, Greece. (9)American Cancer Society, Atlanta, GA Department of Family and Community Medicine, Jefferson Medical College, Thomas Jefferson University, Philadelphia, PA. (10)Oxford Centre for Diabetes, Endocrinology and Metabolism, Churchill Hospital, Oxford, U.K. National Institute for Health Research (NIHR), Oxford Biomedical Research Centre, Oxford, U.K. Harris Manchester College, University of Oxford, Oxford, U.K. Comment in Diabetes Care. 2015 Aug;38(8):e125-6. Diabetes Care. 2015 Aug;38(8):e127. Diabetes Care. 2015 Sep;38(9):e143. Diabetes Care. 2015 Sep;38(9):e141-2. Diabetes Care. 2015 Aug;38(8):e128-9. Dipeptidyl-Peptidase IV In Continue reading >>

Ada Updates Standards Of Medical Care For Patients With Diabetes Mellitus

Ada Updates Standards Of Medical Care For Patients With Diabetes Mellitus

Key Points for Practice • All adults should be tested for diabetes beginning at 45 years of age. • Overweight or obese patients with one or more risk factors for diabetes should be screened at any age. • Persons who use continuous glucose monitoring and insulin pumps should have continued access after 65 years of age. • Aspirin therapy should be considered for women with diabetes who are 50 years and older. • The addition of ezetimibe to statin therapy should be considered for eligible patients who can tolerate only a moderate-dose statin Ongoing patient self-management education and support are critical to preventing acute complications of diabetes mellitus and reducing the risk of long-term complications. The American Diabetes Association (ADA) recently updated its standards of care to provide the components of diabetes care, general treatment goals, and tools to evaluate the quality of care. Key changes in the 2016 update include new screening recommendations, clarification of diagnostic testing, and recommendations on the use of new technology for diabetes prevention, the use of continuous glucose monitoring devices, cardiovascular risk management, and screening for hyperlipidemia in children with type 1 diabetes. General recommendations for treatment of type 2 diabetes are shown in Figure 1. Antihyperglycemic therapy in type 2 diabetes: general recommendations. The order in the chart was determined by historical availability and the route of administration, with injectables to the right; it is not meant to denote any specific preference. Potential sequences of antihyperglycemic therapy for patients with type 2 diabetes are displayed, with the usual transition moving vertically from top to bottom, although horizontal movement within therapy stages is also Continue reading >>

Individualizing Treatment Of Hyperglycemia In Type 2 Diabetes

Individualizing Treatment Of Hyperglycemia In Type 2 Diabetes

From the University of Arizona College of Pharmacy and the University of Arizona College of Medicine-Tucson, Tucson, AZ. ABSTRACT • Objective: To summarize key issues relevant to managing hyperglycemia in patients with type 2 diabetes mellitus (T2DM) and review a strategy for initiating and intensifying therapy. • Methods: Review of the literature. • Results: The 6 most widely used pharmacologic treatment options for hyperglycemia in T2DM are metformin, sulfonylureas, dipeptidyl peptidase-4 inhibitors, glucagon-like peptide-1 receptor agonists, sodium-glucose cotransporter-2 inhibitors, and insulin. Recent guidelines stress the importance of an individualized, patient-centered approach to managing hyperglycemia in T2DM, although sufficient guidance for nonspecialists on how to individualize treatment is often lacking. For patients with no contraindications, metformin should be recommended concurrent with lifestyle intervention at the time of diabetes diagnosis. Due to the progressive nature of T2DM, glycemic control on metformin monotherapy is likely to deteriorate over time, and there is no consensus as to what the second-line agent should be. A second agent should be selected based on glycemic goal and potential advantages and disadvantages of each agent for any given patient. If the patient progresses to the point where dual therapy does not provide adequate control, either a third non-insulin agent or insulin can be added. • Conclusion: Although research is increasingly focusing on what the ideal number and sequence of drugs should be when managing T2DM, investigating all possible combinations in diverse patient populations is not feasible. Physicians therefore must continue to rely on clinical judgment to determine how to apply trial data to the treatment o Continue reading >>

Silvio E Inzucchi, Md

Silvio E Inzucchi, Md

Furie KL, Viscoli CM, Gorman M, Ford GA, Young LH, Inzucchi SE, Guarino PD, Lovejoy AM, Conwit R, Tanne D, Kernan WN, IRIS Trial Investigators.: Effects of pioglitazone on cognitive function in patients with a recent ischaemic stroke or TIA: a report from the IRIS trial. J Neurol Neurosurg Psychiatry. 2018 Jan; 2017 Sep 22. PMID: 28939682 Kohler S, Lee J, George JT, Inzucchi SE, Zinman B: Bladder cancer in the EMPA-REG OUTCOME trial. Diabetologia. 2017 Dec; 2017 Sep 14. PMID: 28913551 Kernan WN, Viscoli CM, Dearborn JL, Kent DM, Conwit R, Fayad P, Furie KL, Gorman M, Guarino PD, Inzucchi SE, Stuart A, Young LH, Insulin Resistance Intervention After Stroke (IRIS) Trial Investigators.: Targeting Pioglitazone Hydrochloride Therapy After Stroke or Transient Ischemic Attack According to Pretreatment Risk for Stroke or Myocardial Infarction. JAMA Neurol. 2017 Nov 1. PMID: 28975241 Young LH, Viscoli CM, Inzucchi SE, Kernan WN: Response by Young et al to Letters Regarding Article, "Cardiac Outcomes After Ischemic Stroke or Transient Ischemic Attack: Effects of Pioglitazone in Patients With Insulin Resistance Without Diabetes Mellitus". Circulation. 2017 Oct 17. PMID: 29038213 Epstein KA, Viscoli CM, Spence JD, Young LH, Inzucchi SE, Gorman M, Gerstenhaber B, Guarino PD, Dixit A, Furie KL, Kernan WN, IRIS Trial Investigators.: Smoking cessation and outcome after ischemic stroke or TIA. Neurology. 2017 Oct 17; 2017 Sep 8. PMID: 28887378 Erfe JM, Perry A, McClaskey J, Inzucchi SE, James WS, Eid T, Bronen RA, Mahajan A, Huttner A, Santos F, Spencer D: Long-term outcomes of tissue-based ACTH-antibody assay-guided transsphenoidal resection of pituitary adenomas in Cushing disease. J Neurosurg. 2017 Oct 13; 2017 Oct 13. PMID: 29027854 Inzucchi SE, Kosiborod M: Oral Pharmacologic Trea Continue reading >>

Type 2 Diabetes Mellitustreatment & Management

Type 2 Diabetes Mellitustreatment & Management

Type 2 Diabetes MellitusTreatment & Management Author: Romesh Khardori, MD, PhD, FACP; Chief Editor: George T Griffing, MD more... The goals in caring for patients with diabetes mellitus are to eliminate symptoms and to prevent, or at least slow, the development of complications. Microvascular (ie, eye and kidney disease) risk reduction is accomplished through control of glycemia and blood pressure; macrovascular (ie, coronary, cerebrovascular, peripheral vascular) risk reduction, through control of lipids and hypertension, smoking cessation, and aspirin therapy; and metabolic and neurologic risk reduction, through control of glycemia. New abridged recommendations for primary care providers The American Diabetes Association has released condensed recommendations for Standards of Medical Care in Diabetes: Abridged for Primary Care Providers , highlighting recommendations most relevant to primary care. The abridged version focusses particularly on the following aspects: Diagnosis and treatment of vascular complications Intensification of insulin therapy in type 2 diabetes The recommendations can be accessed at American Diabetes Association DiabetesPro Professional Resources Online, Clinical Practice Recommendations 2015 . [ 121 ] Type 2 diabetes care is best provided by a multidisciplinary team of health professionals with expertise in diabetes, working in collaboration with the patient and family. [ 2 ] Management includes the following: Appropriate self-monitoring of blood glucose (SMBG) Ideally, blood glucose should be maintained at near-normal levels (preprandial levels of 90-130 mg/dL and hemoglobin A1C [HbA1c] levels < 7%). However, focus on glucose alone does not provide adequate treatment for patients with diabetes mellitus. Treatment involves multiple goals (ie, Continue reading >>

Type 2 Diabetes - References

Type 2 Diabetes - References

Citations American Diabetes Association (2015). Standards of medical care in diabetes-2015. Diabetes Care, 38(Suppl 1): S1-S93. U.S. Department of Health and Human Services (2008). 2008 Physical Activity Guidelines for Americans (ODPHP Publication No. U0036). Washington, DC: U.S. Government Printing Office. Available online: Other Works Consulted American Diabetes Association (2013). Nutrition therapy recommendations for the management of adults with diabetes. Diabetes Care, 36(11): 3821-3842. DOI: 10.2337/dc13-2042. Accessed December 5, 2013. American Diabetes Association (2015). Standards of medical care in diabetes-2015. Diabetes Care, 38(Suppl 1): S1-S93. Bax J, et al. (2007). Screening for coronary artery disease in patients with diabetes. Diabetes Care, 30(10): 2729-2736. Also available online: Brownlee M, et al. (2011). Complications of diabetes mellitus. In S Melmed et al., eds., Williams Textbook of Endocrinology, 12th ed., pp. 1462-1551. Philadelphia: Saunders. Centers for Disease Control and Prevention (2014). National diabetes statistics report: Estimates of diabetes and its burden in the United States, 2014. Centers for Disease Control and Prevention. Accessed July 10, 2014. De Ferranti SD, et al. (2014). Type 1 diabetes mellitus and cardiovascular disease: A scientific statement from the American Heart Association and American Diabetes Association. Diabetes Care, published online August 11, 2014. DOI: 10.2337/dc14-1720. Accessed September 4, 2014. Giovannucci E, et al. (2010). Diabetes and cancer: A consensus report. Diabetes Care, 33(7): 1674-1685. Also available online: Handelsman Y, et al. (2015). American Association of Clinical Endocrinologists and American College of Endocrinology-Clinical practice guidelines for developing a diabetes mellitus compre Continue reading >>

Ttype 2 Diabetes In Adults: Managementype 2 Diabetes In Adults: Management

Ttype 2 Diabetes In Adults: Managementype 2 Diabetes In Adults: Management

YYour responsibilityour responsibility The recommendations in this guideline represent the view of NICE, arrived at after careful consideration of the evidence available. When exercising their judgement, professionals and practitioners are expected to take this guideline fully into account, alongside the individual needs, preferences and values of their patients or the people using their service. It is not mandatory to apply the recommendations, and the guideline does not override the responsibility to make decisions appropriate to the circumstances of the individual, in consultation with them and their families and carers or guardian. Local commissioners and providers of healthcare have a responsibility to enable the guideline to be applied when individual professionals and people using services wish to use it. They should do so in the context of local and national priorities for funding and developing services, and in light of their duties to have due regard to the need to eliminate unlawful discrimination, to advance equality of opportunity and to reduce health inequalities. Nothing in this guideline should be interpreted in a way that would be inconsistent with complying with those duties. Commissioners and providers have a responsibility to promote an environmentally sustainable health and care system and should assess and reduce the environmental impact of implementing NICE recommendations wherever possible. Type 2 diabetes in adults: management (NG28) © NICE 2017. All rights reserved. Subject to Notice of rights (conditions#notice-of-rights). Page 2 of 45 ContentsContents Overview ................................................................................................................................................................................ 5 Who Continue reading >>

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