Current guidelines for the management of hypertension and dyslipidemia have focused on the need to set blood pressure (BP) and lipid targets dependent upon a patient's overall level of CV risk. [4][5][6][7][8] However, despite the high prevalence of concomitant hypertension and dyslipidemia, observational data suggest that fewer than 10% of patients attain recommended therapeutic targets for both conditions.9 Treatment strategies that specifically target overall CV risk rather than individual risk factors are therefore warranted.Amlodipine besylate is a dihydropyridine calcium channel blocker (CCB) approved for the treatment of hypertension and both vasospastic and chronic, stable angina.10 Amlodipine is well tolerated and efficacious at lowering BP. The largest clinical hypertension trial to date, the Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT [n=33,357]), 11 reinforced
Good glycaemic control continues to be the most effective therapeutic manoeuvre to reduce the risk of development and/or progression of microvascular disease, and therefore remains the cornerstone of diabetes management despite recent scepticism about tight glucose control strategies. The impact on macrovascular complications is still a matter of debate, and so glycaemic control strategies should be placed in the context of multifactorial intervention to address all cardiovascular risk factors. Approaches to achieve glycaemic targets should always ensure patient safety, and results from recent landmark outcome studies support the need for appropriate individualisation of glycaemic targets and of the means to achieve these targets, with the ultimate aim to optimise outcomes and minimise adverse events, such as hypoglycaemia and marked weight gain. The primary goal of the Global Partnership for Effective Diabetes Management is the provision of practical guidance to improve patient outcomes and, in this article, we aim to support healthcare professionals in appropriately tailoring type 2 diabetes treatment to the individual. Patient groups requiring special consideration are identified, including newly diagnosed individuals with type 2 diabetes but no complications, individuals with a history of inadequate glycaemic control, those with a history of cardiovascular disease, children and individuals at risk of hypoglycaemia. Practical guidance specific to each group is provided.
The Global Partnership for Effective Diabetes Management, established to provide practical guidance to improve patient outcomes in diabetes, has developed and modified recommendations to improve glycaemic control in type 2 diabetes. The Global Partnership advocates an individualized therapeutic approach and, as part of the process to customize therapy, has previously identified specific type 2 diabetes patient subgroups that require special consideration. This article builds on earlier publications, expanding the scope of practical guidance to include newly diagnosed individuals with complications and women with diabetes in pregnancy. Good glycaemic control remains the cornerstone of managing type 2 diabetes, and plays a vital role in preventing or delaying the onset and progression of diabetic complications. Individualizing therapeutic goals and treatments to meet glycaemic targets safely and without delay remains paramount, in addition to a wider programme of care to reduce cardiovascular risk factors and improve patient outcomes.
The recent United Nations (UN) Resolution on diabetes calls for action to curb the severe risks posed by diabetes and its complications, and encourages member states to improve awareness, treatment and care of diabetes worldwide. Overcoming barriers to good glycaemic control is a pressing need as we work towards fulfilling the UN resolution. In this article, the Global Partnership for Effective Diabetes Management highlights diabetes care strategies worldwide which employ a patient-centered approach that has improved patient care and health outcomes. Examples include implementation of multidisciplinary teams and forging of effective patient partnerships to motivate and empower individuals with type 2 diabetes to take control of their condition. These real-world case studies provide practical ways to facilitate effective diabetes care across the spectrum of resource settings worldwide.
This post hoc analysis of gastrointestinal (GI) adverse events (AEs) from the phase 3 LixiLan‐L (NCT02058160) and LixiLan‐O (NCT02058147) trials aimed to determine the frequency and timing of nausea, vomiting, and diarrhoea for iGlarLixi, a titratable, fixed‐ratio combination of insulin glargine 100 units/mL (iGlar) and lixisenatide, versus iGlar alone or iGlar and lixisenatide alone, in patients with type 2 diabetes uncontrolled with oral antidiabetes drugs (OADs) or basal insulin ± OADs. In iGlarLixi‐treated patients, the rate of GI AEs during the initial weeks of treatment was lower versus patients treated with lixisenatide alone (9.6% and 11.7% of iGlarLixi‐treated patients in LixiLan‐L and LixiLan‐O, respectively, vs. 27.5% of lixisenatide‐treated patients in LixiLan‐O). Beyond day 60, these rates were generally low and similar to those of lixisenatide. These lower rates are likely due to the gradual titration of lixisenatide in iGlarLixi. Median durations of intermittent GI AEs in the iGlarLixi arms were 6.0, 2.0 and 2.5 days (LixiLan‐L), and 5.0, 1.0 and 3.5 days (LixiLan‐O), respectively. iGlarLixi‐associated GI AEs were transient, mostly mild or moderate in severity, and occurred mainly during initial titration.
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