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Management Of Hyperglycemia In Type 2 Diabetes 2015

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 >>

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 >>

Advancements In Individualizing Treatment For Type 2 Diabetes: Discussion Guide

Advancements In Individualizing Treatment For Type 2 Diabetes: Discussion Guide

An increase in the prevalence of diagnosed diabetes mellitus in the United States by 382% was observed between 1988 and 2014. The vast majority (90% to 95%) of patients with diabetes have type 2 disease.[5] Risk factors for developing type 2 diabetes include advanced age, male gender, certain racial or ethnic groups (e.g., American Indians, African Americans, Hispanics/Latinos, Asians, Pacific Islanders), and low socioeconomic status.[3] Type 2 diabetes is characterized by insulin resistance and progressive pancreatic -cell dysfunction resulting in hyperglycemia and target organ damage (i.e., macrovascular and microvascular complications). These changes typically begin long before the disease is diagnosed.[5,6] Glucose homeostasis is maintained in healthy persons by pancreatic -cell release of insulin in response to high blood glucose concentrations, which promotes hepatic and skeletal muscle uptake of glucose and inhibits hepatic glucose production and lipolysis by fat cells. When blood glucose concentrations fall too low, pancreatic -cells release glucagon, which opposes the actions of insulin. Glucagon reduces glucose uptake in hepatic and muscle tissues and increases hepatic glucose production and lipolysis by fat cells. In prediabetes and the early stages of type 2 diabetes, insulin resistance in liver, muscle, and other tissues is largely overcome by compensatory increases in -cell insulin secretion, resulting in mild hyperglycemia.[3] More overt hyperglycemia manifests in later stages of the disease when -cell function deteriorates and insulin secretion is inadequate to compensate for insulin resistance. Persistent hyperglucagonemia contributes to hyperglycemia.[7] Multiple organ systems and tissues appear to be involved in the pathogenesis of type 2 diabetes. D Continue reading >>

Early Insulin Therapy In Patients With Type 2 Diabetes Mellitus

Early Insulin Therapy In Patients With Type 2 Diabetes Mellitus

Journal of Endocrinology, Metabolism and Diabetes of South Africa Type 2 diabetes mellitus (T2DM) is a progressive disease characterised by beta cell dysfunction and insulin resistance. Beta cell dysfunction progresses to beta cell failure. Many patients with T2DM are managed with oral agents until complications develop. Clinical inertia in T2DM, defined as lack of initiation or intensification of therapy when clinically indicated, is common among clinicians. Patients are exposed to hyperglycaemia for a long time resulting in glucotoxicity to beta cells, leading to further beta cell deterioration. The traditional approach to the management of T2DM is lifestyle change, diet, exercise, weight loss, oral agents and, lastly, insulin. This traditional approach is usually carried out step-by-step and at a slow pace, with insulin offered as a last option. By the time insulin therapy is initiated, complications have already developed. It is, therefore, important for clinicians to be aware of the importance of initiating insulin therapy early to prevent poor glycaemic control and the development of diabetes-related complications. Keywords: type 2 diabetes mellitus , clinical inertia , early insulin therapy Type 2 diabetes mellitus (T2DM) is an insulin-insufficient disease characterised pathophysiologically by beta cell dysfunction and insulin resistance. 1 Cohen O. Initiating insulin in type 2 diabetes mellitus: the earlier the better. Isr Med Assoc J. 2004;6:292294. [PubMed] , [Web of Science ] , [Google Scholar] Glycaemic control is important in the management of T2DM to prevent diabetes-related complications. 14 Cohen O. Initiating insulin in type 2 diabetes mellitus: the earlier the better. Isr Med Assoc J. 2004;6:292294. Spellman CW. Insulin therapy for maximal glycaemic c 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 >>

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 >>

Newer Agents In Type 2 Diabetes

Newer Agents In Type 2 Diabetes

A 61-year-old man has a 12-year history of type 2 diabetes. Other medical problems include hypertension, hyperlipidemia, coronary artery disease (CAD), diastolic dysfunction, gout, and benign prostatic hyperplasia (BPH). His current antihyperglycemic regimen consists of metformin and sitagliptin. His blood glucose levels at home have increased over the past year, so that he is now running 150-170 mg/dl range fasting, and frequently >200 mg/dl during the day. His A1c, which had been previously maintained between 7.0% and 7.5%, has increased over the past six months to 8.3%. CAD s/p left anterior descending (LAD) artery stent (drug-eluting) three years ago (last nuclear stress test without ischemia) Social History: Former smoker; no excess alcohol. Works as an accountant. Married withtwo grown children. Family History: Type 2 diabetes in both parents. ROS: No chest pain but mild exertional dyspnea. No edema. Mild obstructive voiding symptoms. Physical Examination: Obese man in no apparent distress. Body mass index (BMI) 35.2 kg/m2. BP 146/92. HR 72 regular RR 18 afebrile. No jugular venous distension. Carotid upstrokes normal. Abdomen obese but no masses or tenderness Normal chemistries; estimated glomerular filtration rate (eGFR) >90 Low-density lipoprotein (LDL) 63, high-density lipoprotein (HDL) 45, TGs 167 Electrocardiogram: Left ventricular hypertrophy (LVH) but no ischemic changes Assessment: 61-year-old man with suboptimal blood glucose control on dual therapy with metformin and a DPP-4 inhibitor, in the setting of well-controlled hypertension and hyperlipidemia and a history of CAD and diastolic dysfunction. Choosing an HbA1c target is the first step in this patient's diabetes care to determine how much further glucose lowering is optimal for him. Based on his ag 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 >>

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 >>

My Site - Chapter 13: Pharmacologic Glycemic Management Of Type 2 Diabetes In Adults

My Site - Chapter 13: Pharmacologic Glycemic Management Of Type 2 Diabetes In Adults

Literature Review Flow Diagram for Chapter 13: Pharmacologic Glycemic Management of Type 2 Diabetes in Adults *Excluded based on: population, intervention/exposure, comparator/control or study design. From: Moher D, Liberati A, Tetzlaff J, Altman DG, The PRISMA Group (2009). Preferred Reporting Items for Systematic Reviews and Meta-Analyses: The PRISMA Statement. PLoS Med 6(6): e1000097. doi:10.1371/journal.pmed1000097 (147) . For more information, visit www.prisma-statement.org . Dr. Goldenberg reports personal fees from Abbott, AstraZeneca, Boehringer Ingelheim, Eli Lilly, Janssen, Merck, Novo Nordisk, Sanofi, and Servier, outside the submitted work. Dr. MacCallum reports personal fees from Janssen and Novo Nordisk, outside the submitted work. No other author has anything to disclose. Gaede P, Lund-Andersen H, Parving HH, et al. Effect of a multifactorial intervention on mortality in type 2 diabetes. N Engl J Med 2008;358:58091. Gregg EW, Chen H, Wagenknecht LE, et al. Association of an intensive lifestyle intervention with remission of type 2 diabetes. JAMA 2012;308:248996. UK Prospective Diabetes Study (UKPDS) Group. Intensive blood-glucose control with sulphonylureas or insulin compared with conventional treatment and risk of complications in patients with type 2 diabetes (UKPDS 33). UK Prospective Diabetes Study (UKPDS) Group. Lancet 1998;352:83753. Stratton IM, Adler AI, Neil HA, et al. Association of glycaemia with macrovascular and microvascular complications of type 2 diabetes (UKPDS 35): Prospective observational study. BMJ 2000;321:40512. Bloomgarden ZT, Dodis R, Viscoli CM, et al. Lower baseline glycemia reduces apparent oral agent glucose-lowering efficacy: A meta-regression analysis. Diabetes Care 2006;29:21379. Sherifali D, Nerenberg K, Pullenayegum E, Continue reading >>

Type 2 Diabetes Mellitus: Outpatient Insulin Management

Type 2 Diabetes Mellitus: Outpatient Insulin Management

In patients with type 2 diabetes mellitus, insulin may be used to augment therapy with oral glycemic medications or as insulin replacement therapy. The American Diabetes Association suggests the use of long-acting (basal) insulin to augment therapy with one or two oral agents or one oral agent plus a glucagon-like peptide 1 receptor agonist when the A1C level is 9% or more, especially if the patient has symptoms of hyperglycemia or catabolism. Insulin regimens should be adjusted every three or four days until targets of self-monitored blood glucose levels are reached. A fasting and premeal blood glucose goal of 80 to 130 mg per dL and a two-hour postprandial goal of less than 180 mg per dL are recommended. Insulin use is associated with hypoglycemia and weight gain. Insulin analogues are as effective as human insulin at lowering A1C levels with lower risk of hypoglycemia, but they have significantly higher cost. Patients with one or more episodes of severe hypoglycemia (i.e., requiring assistance from others for treatment) may benefit from a short-term relaxation of glycemic targets. Several new insulin formulations have been approved recently that are associated with less risk of hypoglycemia compared with older formulations. The goals of therapy should be individualized based on many factors, including age, life expectancy, comorbid conditions, duration of diabetes, risk of hypoglycemia, cost, patient motivation, and quality of life. Type 2 diabetes mellitus is a chronic, progressive disease characterized by multiple defects in glucose metabolism, the core of which is insulin resistance in muscle, liver, and adipocytes and progressive beta cell failure.1 Beta cell failure progresses at a rate of approximately 4% per year, requiring the use of multiple medications, oft Continue reading >>

Recommendations For The Pharmacologic Treatment Of Hyperglycemia In Type 2 Diabetes. Consensus Document | Nefrologa (english Edition)

Recommendations For The Pharmacologic Treatment Of Hyperglycemia In Type 2 Diabetes. Consensus Document | Nefrologa (english Edition)

Recommendations for the pharmacologic treatment of hyperglycemia in type 2 diabetes. Consensus document Recomendaciones para el tratamiento farmacolgico de la hiperglucemia en la diabetes tipo 2. Documento de consenso , E.. Menndez Torre b , J.. Lafita Tejedor b , S.. Artola Menndez b , J.. Miln Nez-Corts c , A.. Alonso Garca d , M.. Puig Domingo e , J.R.. Garca Solans f , F.. lvarez Guisasola g , J.. Garca Alegra h , J.. Mediavilla Bravo i , C.. Miranda Fernndez-Santos j , R.. Romero Gonzlez k b En representaci??n del Grupo de Trabajo de Consensos y Gu??as Cl??nicas de la Sociedad Espa??ola de Diabetes, c Sociedad Espa??ola de Arteriosclerosis (SEA), d Sociedad Espa??ola de Cardiolog??a (SEC), e Sociedad Espa??ola de Endocrinolog??a y Nutrici??n (SEEN), f Sociedad Espa??ola de Farmacia Comunitaria (SEFAC), g Sociedad Espa??ola de Medicina Familiar y Comunitaria (semFYC), h Sociedad Espa??ola de Medicina Interna (SEMI), i Sociedad Espa??ola de M??dicos de Atenci??n Primaria (SEMERGEN), j Sociedad Espa??ola de M??dicos Generales y de Familia (SEMG), k Sociedad Espa??ola de Nefrolog??a (S.E.N.), NOTICE Undefined variable: ruta (includes_ws_v2/librerias/utilidades.php[472]) NOTICE Undefined variable: ruta (includes_ws_v2/librerias/utilidades.php[487]) Type 2 diabetes is a disease characterized by chronic hyperglycaemia secondary to a dual pathogenic mechanism: resistance to the action of insulin combined with a progressive decline in pancreatic insulin secretion. Insulin resistance usually remains throughout the evolution of the disease, but may improve with lifestyle changes (nutritional therapy and exercise), some drugs, and by achieving more favourable anthropometric characteristics. The progressive decline in pancreatic insulin secretion means that taking early and ac Continue reading >>

Changes In Treatment Of Hyperglycemia In A Hypertensive Type 2 Diabetes Population As Renal Function Declines

Changes In Treatment Of Hyperglycemia In A Hypertensive Type 2 Diabetes Population As Renal Function Declines

Despite continued efforts to control hemoglobin A1c (HbA1c) and an ever-expanding arsenal of new drugs [1], we may fall short of adequate control in a significant portion of patients with diabetes due to failure to recognize comorbidities [2]. As kidney disease progresses, clearance of oral agents such as glyburide, metformin or sitagliptan may be so diminished as to require discontinuation. The decrease in renal function due to acute kidney injury and chronic kidney disease (CKD) exacerbates fluid/volume overload, congestive heart failure, high blood pressure [3] as well as other comorbidities. Since there is little data focusing on the impact of renal dysfunction on these therapeutic choices, we examined the effect of renal (dys)function on the choice of antidiabetic medications. To understand the medication decisions in patients with both type 2 diabetes and hypertension, we evaluated the records of all patients seen at least twice during a sample 5-year period at Joslin Diabetes Center. This study was approved by the Committee on Human Studies of the Joslin Diabetes Center as a quality assurance study to determine adherence to quality guidelines. All patient records were anonymized and patient data deidentified prior to analysis. During this time 15 481 patients were seen more than twice and 10 540 individuals had diagnosis codes for both hypertension and diabetes. Of these 10 151 patients were identified as meeting these criteria with complete demographic information regarding height, weight, body mass index (BMI), estimated glomerular filtration rate (eGFR) and medication records available. There were 5623 men and 4528 women with a mean BMI of 31 kg/m2 (men 30, women 32), height 67 inches (69, 63), weight 198 lb (212, 182) and mean eGFR of 78 mL/min/1.73 m2 (78, 7 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 >>

Management Of Hyperglycaemia In Type 2 Diabetes: The 2018 Consensus Report By Ada/easd Insights From One Of The Authors | Davies | British Journal Of Diabetes

Management Of Hyperglycaemia In Type 2 Diabetes: The 2018 Consensus Report By Ada/easd Insights From One Of The Authors | Davies | British Journal Of Diabetes

Management of hyperglycaemia in type 2 diabetes: the 2018 consensus report by ADA/EASD Insights from one of the authors type 2 diabetes, hyperglycaemia, consensus report, adult Davies MJ, DAlessio DA, Fradkin J, et al. Management of hyperglycemia in type 2 diabetes, 2018. A consensus report by the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD). Diabetes Care 2018 Oct 4. [Epub ahead of print]. Davies MJ, DAlessio DA, Fradkin J, et al. Management of hyperglycaemia in type 2 diabetes, 2018. A consensus report by the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD). Diabetologia 2018 Oct 5, [Epub ahead of print]. Inzucchi S, Bergenstal RM, Buse JB, et al. 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. Diabetes Care 2015;38:1409. Nathan D, Buse JB, Davidson MB, et al. Management of hyperglycemia in type 2 diabetes: a consensus algorithm for the initiation and adjustment of therapy. A consensus statement from the American Diabetes Association and the European Association for the Study of Diabetes. Diabetes Care 2006;29:196372. Inzucchi S, Bergenstal RM, Buse JB, et al. Management of hyperglycaemia in type 2 diabetes: a patient-centered approach. Position statement of the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD). Diabetologia 2012;55:157796. National Institute for Health and Care Excellence. Type 2 diabetes in adults: management. Guideline [28]. 2 December 2015, updated May 2017. National Institute for Health and Care Excellence. Type 2 diabetes in adults: manageme Continue reading >>

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