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AACE/ACE Comprehensive Type 2 Diabetes Management Algorithm CONSENSUS STATEMENT BY THE AMERICAN ASSOCIATION OF CLINICAL ENDOCRINOLOGISTS AND AMERICAN COLLEGE OF ENDOCRINOLOGY ON THE COMPREHENSIVE TYPE 2 DIABETES MANAGEMENT ALGORITHM – 2019 EXECUTIVE SUMMARY | Endocrine Practice | | > > > CONSENSUS STATEMENT BY THE AMERICAN ASSOCIATION OF CLINICAL ENDOCRINOL... Volume 25, Issue 1 (January 2019) Alerts for the Journal Click to get an email alert for every new issue of Endocrine Practice X Email (...) , Janet B. McGill , Jeffrey I. Mechanick , Paul D. Rosenblit , and Guillermo E. Umpierrez ( 2019 ) CONSENSUS STATEMENT BY THE AMERICAN ASSOCIATION OF CLINICAL ENDOCRINOLOGISTS AND AMERICAN COLLEGE OF ENDOCRINOLOGY ON THE COMPREHENSIVE TYPE 2 DIABETES MANAGEMENT ALGORITHM – 2019 EXECUTIVE SUMMARY . Endocrine Practice: January 2019, Vol. 25, No. 1, pp. 69-100. AACE/ACE Consensus Statement CONSENSUS STATEMENT BY THE AMERICAN ASSOCIATION OF CLINICAL ENDOCRINOLOGISTS AND AMERICAN COLLEGE OF ENDOCRINOLOGY
Alpha-glucosidase inhibitors for prevention or delay of type 2 diabetes mellitus and its associated complications in people at increased risk of developing type 2 diabetes mellitus. Alpha-glucosidase inhibitors (AGI) reduce blood glucose levels and may thus prevent or delay type 2 diabetes mellitus (T2DM) and its associated complications in people at risk of developing of T2DM.To assess the effects of AGI in people with impaired glucose tolerance (IGT), impaired fasting blood glucose (IFG (...) model with assessment of risk ratios (RRs) for dichotomous outcomes and mean differences (MDs) for continuous outcomes, using 95% confidence intervals (CIs) for effect estimates. We assessed the overall quality of the evidence by using the GRADE instrument.For this update of the Cochrane Review (first published 2006, Issue 4) we included 10 RCTs (11,814 participants), eight investigating acarbose and two investigating voglibose, that included people with IGT or people "at increased risk for diabetes
complications. Key points Prevention. In individuals at risk for type 2 diabetes (see Table 1), type 2 diabetes can be delayed or prevented through diet, exercise, and pharmacologic interventions [IA]. Screening. Although little evidence is available on screening for diabetes, screening should be considered every 3 years beginning at age 45 or annually at any age if BMI = 25 kg/m 2 [evidence: IID], history of hypertension [IIB], gestational diabetes [IC], or other risk factors. Diagnosis. An A1c of 6.5 (...) = generally should not be performed. Level of evidence supporting a diagnostic method or an intervention: A=randomized controlled trials; B=controlled trials, no randomization; C=observational trials; D=opinion of expert panel. 2 UMHS Management of Type 2 Diabetes Mellitus June, 2017 Table 1. Diagnosis of Diabetes: Diagnostic Tests and Glucose Values Diagnostic Test Normal Pre-diabetesDiabetes Hemoglobin A1c (A1c) a 30 mg/gm, check UA to rule out asymptomatic UTI. • Repeat spot urine ratio twice within 6
at www.racgp. org.au/your-practice/business/tools/support. Four of these indicators are relevant to diabetes care: Indicator number Description 1 Practice infrastructure to support safety and quality of patient care 5 Assessment of absolute cardiovascular risk 12 Screening for retinopathy in patients with diabetes 13 Screening for nephropathy in high-risk patients (including diabetes) Use of clinical indicators to assess care is advised but entirely voluntary.10 General practice management of type 2 (...) and Torres Strait Islander peoples should be screened from age 18 years (25) NHMRC, 2009 *Refer to Appendix A for an explanation of the Grade. Clinical context Type 2 diabetes is the most common form of diabetes in Australia, although many cases remain undiagnosed. Additionally, almost 1 in 6 adults are affected by impaired glucose tolerance (IGT) or impaired fasting glucose (IFG). 1 Earlier detection increases opportunities to reduce morbidity and mortality. The Australian Type 2 Diabetes Risk
Newer Drugs for Type 2 Diabetes: An Emerging Adjunctive Therapy to Insulin for Type1Diabetes? Newer Drugs for Type 2 Diabetes: An Emerging Adjunctive Therapy to Insulin for Type1Diabetes? | CADTH.ca CADTH Document Viewer Newer Drugs for Type 2 Diabetes: An Emerging Adjunctive Therapy to Insulin for Type1Diabetes? Table of Contents Search this document Newer Drugs for Type 2 Diabetes: An Emerging Adjunctive Therapy to Insulin for Type1Diabetes? January 2018 Summary There are two major (...) categories of diabetes. Type1diabetes (T1D) is characterized by severe impairment or an absolute deficiency of insulin due to autoimmune destruction of pancreatic cells. Type 2 diabetes (T2D) is characterized by a combination of insulin resistance and decreased insulin secretion. Insulin is the mainstay of treatment for T1D. However, it may be difficult for some patients to reach target glycated hemoglobin (A1C) levels on insulin monotherapy. In some cases, hypoglycemia, excessive glucose fluctuations
to evaluate the guidelines. Guidance Statement 1: Clinicians should personalize goals for glycemic control in patients with type 2 diabetes on the basis of a discussion of benefits and harms of pharmacotherapy, patients' preferences, patients' general health and life expectancy, treatment burden, and costs of care. Guidance Statement 2: Clinicians should aim to achieve an HbA 1c level between 7% and 8% in most patients with type 2 diabetes. Guidance Statement 3: Clinicians should consider deintensifying (...) and any hypoglycemia were more common in the intensive therapy group than the standard therapy group. This included a 3-fold higher rate of episodes with impaired consciousness (9 vs. 3 episodes per 100 patient-years). Serious adverse events were also more common in the intensive therapy group (24.1% vs. 17.6%; P = 0.05); dyspnea was the most common ( P = 0.006) ( ). Guidance Statements Guidance Statement 1: Clinicians should personalize goals for glycemic control in patients with type 2 diabetes
diabetes. Recommendation 1: ACP recommends that clinicians prescribe metformin to patients with type 2 diabetes when pharmacologic therapy is needed to improve glycemic control. (Grade: strong recommendation; moderate-quality evidence) Recommendation 2: ACP recommends that clinicians consider adding either a sulfonylurea, a thiazolidinedione, an SGLT-2 inhibitor, or a DPP-4 inhibitor to metformin to improve glycemic control when a second oral therapy is considered. (Grade: weak recommendation; moderate (...) reached $245 billion in 2012 ( ). Management of type 2 diabetes often includes lifestyle modification and pharmacologic therapy. In the United States, several unique classes of drugs are approved by the U.S. Food and Drug Administration (FDA) to treat hyperglycemia in type 2 diabetes, all of which vary regarding cost and harms. Most adults diagnosed with type 2 diabetes receive treatment with oral medications only rather than injection medications, such as insulin or glucagon-like peptide-1 (GLP-1
and Department of Defense (VA and DoD) healthcare delivery systems, which includes Veterans, deployed and non-deployed Active Duty Service Members, and their adult family Refer to the original guideline document for specific populations for key questions. Note : This clinical practice guideline (CPG) does not provide recommendations for the management of DM in children, adolescents, or pregnant/nursing women. General approach to type 2 diabetes mellitus care Shared decision-making Individualized diabetes (...) a diagnosis of type 2 diabetes mellitus (T2DM). If the percentage is less than 80%, then data must have been reported separately for this patient subgroup. Key Question Specific Criteria For KQ 1, acceptable study designs included SRs, randomized controlled trials (RCTs), including follow-up studies of RCTs, cohorts and pre-planned, prospective analyses of those studies. Retrospective analyses were not included. For KQs 2-4, 8, and 9, acceptable study designs included SRs of RCTs and/or individual RCTs
Psychological interventions for diabetes-related distress in adults with type 2 diabetes mellitus. Many adults with type 2 diabetes mellitus (T2DM) experience a psychosocial burden and mental health problems associated with the disease. Diabetes-related distress (DRD) has distinct effects on self-care behaviours and disease control. Improving DRD in adults with T2DM could enhance psychological well-being, health-related quality of life, self-care abilities and disease control, also reducing (...) depressive symptoms.To assess the effects of psychological interventions for diabetes-related distress in adults with T2DM.We searched the Cochrane Library, MEDLINE, Embase, PsycINFO, CINAHL, BASE, WHO ICTRP Search Portal and ClinicalTrials.gov. The date of the last search was December 2014 for BASE and 21 September 2016 for all other databases.We included randomised controlled trials (RCTs) on the effects of psychological interventions for DRD in adults (18 years and older) with T2DM. We included trials
AACE/ACE Comprehensive Type 2 Diabetes Management Algorithm ENDOCRINE PRACTICE Vol 24 No. 1 January 2018 91 AACE/ACE Consensus Statement CONSENSUS STATEMENT BY THE AMERICAN ASSOCIATION OF CLINICAL ENDOCRINOLOGISTS AND AMERICAN COLLEGE OF ENDOCRINOLOGY ON THE COMPREHENSIVE TYPE 2 DIABETES MANAGEMENT ALGORITHM – 2018 EXECUTIVE SUMMARY Alan J. Garber, MD, PhD, FACE 1 ; Martin J. Abrahamson, MD 2 ; Joshua I. Barzilay, MD, FACE 3 ; Lawrence Blonde, MD, FACP , MACE 4 ; Zachary T. Bloomgarden, MD (...) This algorithm for the comprehensive management of persons with type 2 diabetes (T2D) was developed to provide clinicians with a practical guide that considers the whole patient, his or her spectrum of risks and complica- tions, and evidence-based approaches to treatment. It is now clear that the progressive pancreatic beta-cell defect that drives the deterioration of metabolic control over time begins early and may be present before the diagnosis of diabetes (1). In addition to advocating glycemic control
Adult Type1diabetes mellitus Adult type1diabetes mellitus National Clinical Guideline No. 17 National Patient Safety Office Oifig Náisiúnta um Shábháilteacht Othar June 2018This National Clinical Guideline for adults with type1diabetes has been developed by the Guideline Development Group, supported by the HSE National Clinical Programme for Diabetes. Part of the process of developing this guideline involved contextualising (for Ireland) the National Institute for Health and Care (...) Excellence (NICE) NG17 “Type1diabetes in adults: diagnosis and management” guideline, published in 2015. Using this National Clinical Guideline This National Clinical Guideline applies to adults (aged 18 years and older) with type1diabetes in Ireland. It does not apply to children living with type1diabetes, adults living with type 2 diabetes or individuals living with monogenic (or other rarer forms of) diabetes. This National Clinical Guideline is relevant to all healthcare professionals working
A Practical Approach to the Management of Continuous Glucose Monitoring (CGM) / Real-Time Flash Glucose Scanning (FGS) in Type1Diabetes Mellitus in Children and Young People Under 18 years 1 Version 3, Oct 2018 Review 2021 Authors: ACDC Guideline Development Group N Wright, SM Ng, JC Agwu, P Adolfsson, J Drew, J Pemberton, M Kershaw, S Bissell, C Moudiotis, F Regan, C Gardner, A Astle, A Adams, G Adams, P Manning, A Timmis, A Soni, E Williams ssociation of Children ’s Diabetes Clinicians (...) FOR STAFF Healthcare professionals involved in care of children and young people with Type1Diabetes Mellitus PATIENTS Children and young people with diabetes mellitus This guideline is intended for use in managing continuous glucose monitoring (CGM) or real-time flash glucose scanning (FGS) for all children and young people under 18 years with Type1diabetes mellitus. Table of Contents Introduction 2 Overview of Pertinent NICE guidance 3 Devices Available for CGM and FGS 6 Section 1: Evidence
synthesized the established clinical guidelines and clinical targets for the contemporary management of patients with type 2 diabetes mellitus to reduce CVD risk. When possible, we have included the AHA/American College of Cardiology (ACC) Class of Recommendation/Level of Evidence grading system ( ) or the ADA evidence grading system for clinical practice recommendations ( ). Table 1. Applying Classification of Recommendations and Level of Evidence Table 2. ADA Evidence Grading System for Clinical (...) (BMI ≥35 kg/m 2 ) after weight loss procedures. A meta-analysis involving 19 studies (mostly observational) and 4070 patients reported an overall type 2 diabetes mellitus resolution rate of 78% after bariatric surgery. Resolution was typically defined as becoming nondiabetic with normal A 1c without medications. Most of these studies, however, were retrospective, with follow-up of only 1 to 3 years on average, and varied by type of procedure. A 1c typically improved from baseline by a minimum of 1
Dipeptidyl-peptidase (DPP)-4 inhibitors and glucagon-like peptide (GLP)-1 analogues for prevention or delay of type 2 diabetes mellitus and its associated complications in people at increased risk for the development of type 2 diabetes mellitus. The projected rise in the incidence of type 2 diabetes mellitus (T2DM) could develop into a substantial health problem worldwide. Whether dipeptidyl-peptidase (DPP)-4 inhibitors or glucagon-like peptide (GLP)-1 analogues are able to prevent or delay (...) T2DM and its associated complications in people at risk for the development of T2DM is unknown.To assess the effects of DPP-4 inhibitors and GLP-1 analogues on the prevention or delay of T2DM and its associated complications in people with impaired glucose tolerance, impaired fasting blood glucose, moderately elevated glycosylated haemoglobin A1c (HbA1c) or any combination of these.We searched the Cochrane Central Register of Controlled Trials; MEDLINE; PubMed; Embase; ClinicalTrials.gov; the World
Dapagliflozin/metformin (type 2 diabetes mellitus) - Benefit assessment according to §35a Social Code Book V (new scientific findings) Extract 1 Translation of Sections 2.1 to 2.6 of the dossier assessment Dapagliflozin/Metformin (Diabetes mellitus Typ 2) – Nutzenbewertung gemäß § 35a SGB V (Version 1.0; Status: 28 March 2018). Please note: This translation is provided as a service by IQWiG to English-language readers. However, solely the German original text is absolutely authoritative (...) and legally binding. IQWiG Reports A17-66 Dapagliflozin/metformin (type 2 diabetes mellitus) – Benefit assessment according to §35a Social Code Book V 1 (new scientific findings) Extract of dossier assessment A17-66 Version 1.0 Dapagliflozin/metformin (type 2 diabetes mellitus) 28 March 2018 Institute for Quality and Efficiency in Health Care (IQWiG) - i - Publishing details Publisher: Institute for Quality and Efficiency in Health Care Topic: Dapagliflozin/metformin (type 2 diabetes mellitus) – Benefit
Guidelines on the treatment of Blood Cholesterol 55 NACCHO Preventative Health Guideline (2012) 55 Australian Dietary Guidelines (2013) 54 Part I References 56 Appendix 1: Expert Panel 67 Appendix 2: Project Executive 69 Appendix 3: Guidelines Advisory Committee 70 Appendix 4: Implementation Committee 71 Appendix 5: Baker IDI Conflicts of Interest: Policy and Processes 72 1 Summary The prevalence of type 2 diabetes is rapidly rising. This has major public health implications as type 2 diabetes is a major (...) situations C Body of evidence provides some support for recommendation(s) but care should be taken in its application D Body of evidence is weak and recommendation must be applied with caution Management – Blood Pressure EBR 1 All adults with type 2 diabetes and known prior cardiovascular disease should receive blood pressure lowering therapy unless contra-indicated or clinically inappropriate. (Grade A)[1, 2] Pg 18 PP1 Evidence of the effectiveness of BP lowering therapy for the prevention