Comprehensive approach to people with type 2 diabetes. Diabetes Knowledge Area of the Spanish Society of Endocrinology and Nutrition

Reyes-García, Rebeca; Moreno-Pérez, Óscar; Bellido, Virginia; Botana-López, Manuel; Rodríguez-Hervada, Alejandra Duran; Fernández-García, Diego; Fernández‐García, José Carlos; Gargallo-Fernández, Manuel; González-Clemente, José Miguel; Jódar-Gimeno, Esteban; Casares, Martín López de la Torre; López-Fernández, Judith; Martínez, Amparo Marco; Mezquita-Raya, Pedro; Rozas-Moreno, Pedro; Tejera-Pérez, Cristina; Martı́n, Javier

doi:10.1016/j.endien.2023.03.002

Cited by 3 publications

(5 citation statements)

References 5 publications

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“…Type 2 diabetes guidelines recommend glucagon‐like peptide‐1 receptor agonists (GLP‐1 RAs) and/or sodium‐glucose co‐transporter‐2 inhibitors for people living with type 2 diabetes (PLWT2D) with an established or high risk of cardiovascular disease and/or renal disease, regardless of glycated haemoglobin (HbA1c) levels 1–3 . Semaglutide is the first and only GLP‐1 RA available for oral use.…”

Section: Introductionmentioning

confidence: 99%

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Real‐world effectiveness and safety of oral semaglutide in people living with type 2 diabetes: A nationwide multicentre retrospective observational study (ENDO²S‐RWD)

Moreno‐Pérez,

Reyes‐Garcia,

Modrego‐Pardo

et al. 2023

Diabetes Obesity Metabolism

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Section: Introductionmentioning

confidence: 99%

“…established or high risk of cardiovascular disease and/or renal disease, regardless of glycated haemoglobin (HbA1c) levels. [1][2][3] Semaglutide is the first and only GLP-1 RA available for oral use. Despite its proven safety and efficacy in randomized clinical trials, 4,5 insights into its realworld use in clinical settings are needed.…”

mentioning

confidence: 99%

Real‐world effectiveness and safety of oral semaglutide in people living with type 2 diabetes: A nationwide multicentre retrospective observational study (ENDO²S‐RWD)

Moreno‐Pérez,

Reyes‐Garcia,

Modrego‐Pardo

et al. 2023

Diabetes Obesity Metabolism

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“…SGLT2is are the glucose-lowering agents of choice in patients with T2D and CKD from the perspective of protecting target organs [ 56 , 62 , 63 ], particularly in CKD, but one-fourth of patients treated with these molecules progress to KDIGO risk status, regardless of baseline risk category [ 64 ], and DATA is fully complementary to address residual risk.…”

Section: Therapeutic Translation: Dysfunctional Adipose Tissue Approa...mentioning

confidence: 99%

“…Early, intensive adjuvant combination pharmacotherapy with impact on glucose homeostasis is recommended for most PWT2D, prioritizing insulin-sensitising drugs such as metformin or pioglitazone unless contraindicated [ 56 , 63 ]. In certain clinical scenarios, adjunctive use of insulin may be necessary.…”

Section: Therapeutic Translation: Dysfunctional Adipose Tissue Approa...mentioning

confidence: 99%

Are we ready for an adipocentric approach in people living with type 2 diabetes and chronic kidney disease?

Moreno-Pérez,

Reyes-García,

Modrego-Pardo

et al. 2024

Clinical Kidney Journal

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We are entering a new era in the management of adiposity-based chronic disease (ABCD) with type 2 diabetes (T2D) and related chronic kidney disease (CKD). ABCD, T2D and CKD can affect almost every major organ system and have a particularly strong impact on the incidence of cardiovascular disease (CVD) and heart failure. ABCD and the associated insulin resistance are at the root of many cardiovascular, renal and metabolic (CKM) disorders, thus an integrated therapeutic framework using weight loss (WL) as a disease-modifying intervention could simplify the therapeutic approach at different stages across the lifespan. The breakthrough of highly effective WL drugs makes achieving a WL of >10% possible, which is required for a potential T2D disease remission as well as for prevention of microvascular disease, CKD, CVD events and overall mortality. The aim of this review is to discuss the link between adiposity and CKM conditions as well as placing weight management at the centre of the holistic CKM syndrome approach with a focus on CKD. We propose the clinical translation of the available evidence into a transformative Dysfunctional Adipose Tissue Approach (DATA) for people living with ABCD, T2D and CKD. This model is based on the interplay of four essential elements (i.e. adipocentric approach and target organ protection, dysfunctional adiposity, glucose homeostasis, and lifestyle intervention and de-prescription) together with a multidisciplinary person-centred care. DATA could facilitate decision-making for all clinicians involved in the management of these individuals, and if we do this in a multidisciplinary way, we are prepared to meet the adipocentric challenge.

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“…Besides glycaemic control, the updated T2D management guidelines emphasise simultaneous management of glycaemia and body weight with use of medications that provide cardio-renal protection [ 5 , 6 ]. Most of the guidelines recommend individualising medication choice and treatment targets/goals based on patient characteristics [such as cardiovascular (CV) risk, comorbidities, and psychosocial determinants] as well as patient preferences [ 5 – 9 ]. Timely initiation and intensification of basal insulin (BI) is further recommended in case of inappropriate glycaemic control.…”

Section: Introductionmentioning

confidence: 99%

Expert Opinion on Current Trends in the Use of Insulin in the Management of People with Type 2 Diabetes from the South-Eastern European Region and Israel

Tabak,

Kempler,

Guja

et al. 2024

Diabetes Ther

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Despite the availability of various antihyperglycaemic therapies and comprehensive guidelines, glycaemic control in diabetes management has not improved significantly during the last decade in the real-world clinical setting. Treatment inertia arising from a complex interplay among patient-, clinician- and healthcare-system-related factors is the prime reason for this suboptimal glycaemic control. Also, the key factor leading to inadequate glycaemic levels remains limited communication between healthcare professionals (HCPs) and people with type 2 diabetes (PwT2D). Early insulin administration has several advantages including reduced glucotoxicity, high efficacy and preserved β-cell mass/function, leading to lowering the risk of diabetes complications. The current publication is based on consensus of experts from the South-Eastern European region and Israel who reviewed the existing evidence and guidelines for the treatment of PwT2D. Herein, the experts emphasised the timely use of insulin, preferably second-generation basal insulin (BI) analogues and intensification using basal-plus therapy, as the most-potent glucose-lowering treatment choice in the real-world clinical setting. Despite an increase in the use of glucagon-like peptide-1 receptor agonists (GLP-1 RAs), the experts urged timely insulin initiation for inadequate glycaemic control in PwT2D. Furthermore, the combination of BI and GLP-1 RA addressing both fasting plasma glucose and post-prandial excursions as a free- or fixed-ratio combination was identified to reduce treatment complexity and burden. To minimise discontinuation and improve adherence, the experts reiterated quality, regular interactions and discussions between HCPs and PwT2D/carers for their involvement in the diabetes management decision-making process. Clinicians and HCPs should consider the opinions of the experts in accordance with the most recent recommendations for diabetes management.

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Comprehensive approach to people with type 2 diabetes. Diabetes Knowledge Area of the Spanish Society of Endocrinology and Nutrition

Cited by 3 publications

References 5 publications

Real‐world effectiveness and safety of oral semaglutide in people living with type 2 diabetes: A nationwide multicentre retrospective observational study (ENDO²S‐RWD)

Real‐world effectiveness and safety of oral semaglutide in people living with type 2 diabetes: A nationwide multicentre retrospective observational study (ENDO²S‐RWD)

Are we ready for an adipocentric approach in people living with type 2 diabetes and chronic kidney disease?

Expert Opinion on Current Trends in the Use of Insulin in the Management of People with Type 2 Diabetes from the South-Eastern European Region and Israel

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Comprehensive approach to people with type 2 diabetes. Diabetes Knowledge Area of the Spanish Society of Endocrinology and Nutrition

Cited by 3 publications

References 5 publications

Real‐world effectiveness and safety of oral semaglutide in people living with type 2 diabetes: A nationwide multicentre retrospective observational study (ENDO2S‐RWD)

Real‐world effectiveness and safety of oral semaglutide in people living with type 2 diabetes: A nationwide multicentre retrospective observational study (ENDO2S‐RWD)

Are we ready for an adipocentric approach in people living with type 2 diabetes and chronic kidney disease?

Expert Opinion on Current Trends in the Use of Insulin in the Management of People with Type 2 Diabetes from the South-Eastern European Region and Israel

Contact Info

Product

Resources

About

Real‐world effectiveness and safety of oral semaglutide in people living with type 2 diabetes: A nationwide multicentre retrospective observational study (ENDO²S‐RWD)

Real‐world effectiveness and safety of oral semaglutide in people living with type 2 diabetes: A nationwide multicentre retrospective observational study (ENDO²S‐RWD)