New diabetes pharmacology guidelines focus on individualized approach

According to the International Diabetes Federation (IDF), 50.8 million Indians (7.1% of adults) suffer from diabetes, making India the country with the most diabetics worldwide. The IDF estimates that diabetes kills about 1 million residents of India each year.

In a new joint position statement published by the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD), these organizations have moved away from the highly prescriptive algorithmic approach to the management of Type 2 diabetes recommended in their 2009 position statement, in favor of[s2If !is_user_logged_in()]…

[/s2If][s2If is_user_logged_in()] a more individualized patient-centered approach.

The full statement can be found in either Diabetes Care or Diabetologia, and was published concurrently online and ahead-of-print in both journals this April 2012. The article also contains supplementary recommendations available online at: http://care.diabetesjournals.org/lookup/suppl/doi:10.2337/dc12-0413/-/DC1.

Key Point: A more patient-specific approach is now recommended for the pharmacologic management of type 2 diabetes compared with prior guidance. Glycemic control targets may vary by patient, lifestyle modifications are still important, HbA1c levels should be tied to patient history and risk for severe hypoglycemia, metformin is an optimal first-line agent, and aggressive management of cardiovascular risk factors is key.

Key recommendations of the new position statement included:

  • individualization of glycemic control targets and treatments according to patient-specific characteristics and considering their preferences, needs, and values;
  • diet, exercise, and education remain cornerstones of the proper management of type 2 diabetes;
  • lowering hemoglobin A1c levels to less than 7% in most patients to reduce the incidence of microvascular disease, BUT with more or less stringent goals in patients based upon their history and risk for severe hypoglycemia;
  • metformin is the optimal first-line agent for most patients (assuming no contraindications); and
  • aggressive management of cardiovascular risk factors (ie, blood pressure and lipid therapy, antiplatelet treatment, and smoking cessation) is required.

Source: Inzucchi SE, Bergenstal RM, Buse JB, et al. Management of hyperglycemia 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). Diabetes Care. April 10, 2012 [Epub ahead of print].

Access the original journal information here:
http://care.diabetesjournals.org/content/early/2012/04/17/dc12-0413.full.pdf+html
Journal publishers are independent from mdCurrent-India and may require a subscription or charge a fee to download the full article.

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This entry was posted in Cardiovascular, Cardiovascular Disease, Diabetes, Non-Communicable Disease, Pharmacology, Primary Care and tagged , , , , , , , , , , . Volume: .

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