2019 Update to: 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 - Tập 43 Số 2 - Trang 487-493 - 2020
John B. Buse1, Deborah J. Wexler2,3, Απόστολος Τσάπας4, Peter Rossing5,6, Geltrude Mingrone7,8,9, Chantal Mathieu10, David A. D’Alessio11, Melanie J. Davies12
1Department of Medicine, University of North Carolina School of Medicine, Chapel Hill, NC
2Department of Medicine and Diabetes Unit, Massachusetts General Hospital, Boston, MA
3Harvard Medical School, Boston, MA
4Second Medical Department, Aristotle University Thessaloniki, Thessaloniki, Greece
5Steno Diabetes Center Copenhagen, Gentofte, Denmark
6University of Copenhagen, Copenhagen, Denmark
7Diabetes and Nutritional Sciences, King's College London, London, U.K.
8Fondazione Policlinico Universitario A. Gemelli, IRCCS, Rome, Italy
9Università Cattolica del Sacro Cuore, Rome, Italy
10Clinical and Experimental Endocrinology, UZ Gasthuisberg, KU Leuven, Leuven, Belgium
11Department of Medicine, Duke University School of Medicine, Durham, NC
12Diabetes Research Centre, University of Leicester, Leicester General Hospital, Leicester, U.K.

Tóm tắt

The American Diabetes Association and the European Association for the Study of Diabetes have briefly updated their 2018 recommendations on management of hyperglycemia, based on important research findings from large cardiovascular outcomes trials published in 2019. Important changes include: 1) the decision to treat high-risk individuals with a glucagon-like peptide 1 (GLP-1) receptor agonist or sodium–glucose cotransporter 2 (SGLT2) inhibitor to reduce major adverse cardiovascular events (MACE), hospitalization for heart failure (hHF), cardiovascular death, or chronic kidney disease (CKD) progression should be considered independently of baseline HbA1c or individualized HbA1c target; 2) GLP-1 receptor agonists can also be considered in patients with type 2 diabetes without established cardiovascular disease (CVD) but with the presence of specific indicators of high risk; and 3) SGLT2 inhibitors are recommended in patients with type 2 diabetes and heart failure, particularly those with heart failure with reduced ejection fraction, to reduce hHF, MACE, and CVD death, as well as in patients with type 2 diabetes with CKD (estimated glomerular filtration rate 30 to ≤60 mL min–1 [1.73 m]–2 or urinary albumin-to-creatinine ratio >30 mg/g, particularly >300 mg/g) to prevent the progression of CKD, hHF, MACE, and cardiovascular death.

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Tài liệu tham khảo

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Diabetes Care

Tập 43 Số 2

487-493

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