Θεραπευτικός αλγόριθμος για το διαβήτη τύπου 2 από τις ADA και EASD – 2018
2018: Ο νέος αναθεωρημένος κοινός θεραπευτικός αλγόριθμος για τον Σακχαρώδη Διαβήτη τύπου 2 από τις American Diabetes Association (ADA) και European Association for the Study of Diabetes (EASD)
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The American Diabetes Association and the European Association for the Study of Diabetes convened a panel to update the prior position statements, published in 2012 and 2015, on the management of type 2 diabetes in adults. A systematic evaluation of the literature since 2014 informed new recommendations. These include additional focus on lifestyle management and diabetes self-management education and support. For those with obesity, efforts targeting weight loss, including lifestyle, medication, and surgical interventions, are recommended. With regards to medication management, for patients with clinical cardiovascular disease, a sodium – glucose cotransporter 2 (SGLT2) inhibitor or a glucagon-like peptide 1 (GLP-1) receptor agonist with proven cardiovascular benefit is recommended. For patients with chronic kidney disease or clinical heart failure and atherosclerotic cardiovascular disease, an SGLT2 inhibitor with proven benefitis recommended. GLP-1 receptor agonists are generally recommended as the first injectable medication. The goals of treatment for type 2 diabetes are to prevent or delay complications and maintain quality of life(Fig.1).This requires control of glycemia and cardiovascular risk factor management,regular follow-up,and,importantly,a patient-centered approach to enhance patient engagement in self-care activities (1). Careful consideration of patient factors and preferences must inform the process of individualizing treatment goals and strategies (2,3). This consensus report addresses the approaches to management of glycemia in adults with type 2 diabetes, with the goal of reducing complications and maintaining quality of life in the context of comprehensive cardiovascular risk management and patient-centered care. The principles of how this can be achieved are summarized in Fig. 1 and underpin the approach to management and care. These recommendations are not generally applicable to patients with monogenicdiabetes, secondarydiabetes, or type 1 diabetes, or to children.
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Spyridon Karamagkiolis, MD Diabetes Specialist - Agrinio, Larissa Greece Σπύρος Καραμαγκιώλης, Πιστοποιημένος Διαβητολόγος - Αγρίνιο, Λάρισα