Consensus Statement by the American Association of Clinical Endocrinologists and American College of Endocrinology on the Comprehensive Type 2 Diabetes Management Algorithm – 2020 Executive Summary

Garber, Alan J.; Handelsman, Yehuda; Grunberger, George; Einhorn, Daniel; Abrahamson, Martin J.; Barzilay, Joshua I.; Blonde, Lawrence; Bush, Michael D.; DeFronzo, Ralph A.; Garber, Jeffrey R.; Garvey, W. Timothy; Hirsch, Irl B.; Jellinger, Paul S.; McGill, Janet B.; Mechanick, Jeffrey I.; Perreault, Leigh; Rosenblit, Paul D.; Samson, Susan L.; Umpiérrez, Guillermo E.

doi:10.4158/cs-2019-0472

Cited by 454 publications

(486 citation statements)

References 290 publications

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“…Но, к сожалению, несмотря на широкий ассортимент препаратов, используемых в практической эндокринологии, все они не дают желаемой компенсации нарушенных метаболических сдвигов и обладают рядом побочных эффектов, резко снижающих качество жизни больных, а в некоторых случаях -приводящих к необратимым последствиям для здоровья пациента. Поэтому на сегодняшний день остается актуальным изыскание многофакторных препаратов, действующих на все патогенетические звенья сахарного диабета [3], и их всестороннее исследование [11]. В значительной степени течение СД, а также его профилактику можно облегчить при использовании лекарственных растений.…”

Section: Discussionunclassified

Ефективний Варіант Лікування Цукрового Діабету 2-Го Типу

Чернявська¹,

Zemlianitsyna²,

Romanova³

et al. 2021

Mìžnarodnij endokrinologìčnij žurnal

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Введение Сахарный диабет (СД) 2-го типа является важнейшей медико-социальной проблемой современности, что обусловлено его значительной распространенностью, высокой инвалидизацией и смертностью больных, страдающих данным заболеванием. По определению экспертов Всемирной организации здравоохранения, сахарный диабет является проблемой всех возрастов и всех стран [1]. В настоящее время СД занимает третье место среди непосредственных причин смерти после сердечно-сосудистых и онкологических заболеваний, поэтому решение вопросов, связанных с этим заболеванием, поставлено во многих странах мира на государственный уровень [2]. По данным Международной федерации диабета (IDF), в 2015 году количество людей с СД в возрасте от 20 до 79 лет достигло 415 млн, включая 193 млн случаев недиагностированного диабета, что в четыре раза превышает показатели 1980 года, и, по прогнозам IDF, к 2040 году достигнет 642 млн. Число людей с диабетом после 35 лет возросло с 108 млн в 1980 году до 415 млн в 2015 году [3]. Известно, что преждевременная инвалидизация и смертность больных СД 2-го типа в первую очередь связаны с его макроваскулярными осложнениями, а именно с теми или иными проявлениями атеросклероза (ишемическая болезнь сердца, острый инфаркт миокарда, инсульт, гангрена нижних конечностей и пр.) [4, 5].

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Section: Discussionunclassified

Ефективний Варіант Лікування Цукрового Діабету 2-Го Типу

Чернявська¹,

Zemlianitsyna²,

Romanova³

et al. 2021

Mìžnarodnij endokrinologìčnij žurnal

View full text Add to dashboard Cite

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“…Eu-DKA is a rare complication in T2DM patients on SGLT2 inhibitors, with a range of 0.16–0.76 events per 1000 patients-year [ 9 , 18 , 19 ], but recently some authors recommended that insulin-deficient patients or those using SGLT2 inhibitors should monitor for ketosis using available home testing kits in case of infections.…”

Section: Discussionmentioning

confidence: 99%

COVID-19-associated euglycemic diabetic ketoacidosis in a patient with type 2 diabetes on SGLT2 inhibitor: a case report

et al. 2020

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Type 2 diabetes mellitus (DM) patients are at high risk for the development of severe COVID-19. Euglycemic diabetic ketoacidosis (eu-DKA) is a rare life-threatening complication associated with the use of SGLT2 inhibitor that may be unnoticed, particularly in a pandemic setting, due to the absence of significant hyperglycemia, delaying its treatment. In this report, we describe a case of a 56-year-old patient who presented an elevated anion gap metabolic acidosis during a SARS-CoV-2 infection and was diagnosed with SGLT2-associated euglycemic diabetic ketoacidosis. COVID-19 may increase patients’ insulin demand, present gastrointestinal symptoms, and increase the production of ketone bodies. This situation can be worsened in susceptible diabetic patients on SLGT2 inhibitors, due to the persistent glycosuria, which can cause volume depletion. Recently some authors recommended that insulin-deficient patients or those using SGLT2 inhibitors should monitor for ketosis using available home testing kits in case of infections and should discontinue the medication in case of COVID-19. Given the increased use of this drug class in the management of type 2 DM patients due to its reduction of cardiovascular risk, we set out to emphasize the importance for the medical community to consider the possibility of eu-DKA on SARS-CoV-2-infected patients using SLGT2 inhibitors, so physicians can provide these patients with appropriate therapy promptly.

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“…The ADA also recommends that persons with diabetes using CGM should engage in CGM use daily for maximal benefit and that intermittently scanned devices should be scanned at a minimum of once every 8 hours 4 . The American Association of Clinical Endocrinologists (AACE) recommends that CGM be used in all patients who have severe hypoglycemia, or hypoglycemia unawareness, or whenever indicated in persons with type 1 or type 2 diabetes to assist patients in reaching glycemic goals safely 5,6 . The ADA and AACE also recommend professional‐use CGM in addition to diabetes self‐management education and medication therapy management to improve glycemic management in persons with type 1 and type 2 diabetes 4‐6 .…”

Section: Candidates and Coverage For Cgmmentioning

confidence: 99%

“…The American Association of Clinical Endocrinologists (AACE) recommends that CGM be used in all patients who have severe hypoglycemia, or hypoglycemia unawareness, or whenever indicated in persons with type 1 or type 2 diabetes to assist patients in reaching glycemic goals safely 5,6 . The ADA and AACE also recommend professional‐use CGM in addition to diabetes self‐management education and medication therapy management to improve glycemic management in persons with type 1 and type 2 diabetes 4‐6 . Examples of persons with diabetes who may benefit from professional‐use CGM are further described in Table 3 8…”

Section: Candidates and Coverage For Cgmmentioning

confidence: 99%

“…Adoption of CGM technology has grown rapidly over the past few years with numerous studies demonstrating the clinical benefit in persons with diabetes, especially, for those taking multiple daily insulin injections or using insulin pump therapy 1,3 . Diabetes organizations advocate for CGM use as there are numerous benefits observed in clinical studies including reduced hemoglobin A1c (HbA1c), hypoglycemic events, time spent above the target range, and glycemic variability 4‐7 . Other identified benefits include the ability to assess nocturnal glucose patterns, increased data availability to adjust medication therapy regimens, and improved patient education and engagement 8,9 .…”

Section: Introductionmentioning

confidence: 99%

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Use of continuous glucose monitoring to improve glycemic management: A clinician's guide

Schumacher

Isaacs

Collier

et al. 2020

J Am Coll Clin Pharm

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Adoption of continuous glucose monitoring (CGM) technology in clinical practice has increased over the past few years with numerous studies demonstrating its benefit in persons with diabetes. In addition, the use of CGM systems is now recommended in multiple guidelines for diabetes care. Implementation of personal‐ and professional‐use CGM technology can facilitate patient‐centered discussions in clinical decision making and empower behavioral change. Pharmacists can incorporate CGM into diabetes management practices to help optimize therapy and overcome therapeutic inertia. This “how to” guide is written for pharmacists who are interested in integrating CGM into their clinical practice to improve care for those living with diabetes. It provides an overview of the different CGM systems available and describes the differences between personal‐ and professional‐use CGM to facilitate decision making for use in clinical practice. It also discusses considerations for use, candidates for coverage, billing for CGM services, data interpretation, and documentation. Lessons learned and advice for implementing into clinical practice are also provided.

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Consensus Statement by the American Association of Clinical Endocrinologists and American College of Endocrinology on the Comprehensive Type 2 Diabetes Management Algorithm – 2020 Executive Summary

Cited by 454 publications

References 290 publications

Ефективний Варіант Лікування Цукрового Діабету 2-Го Типу

Ефективний Варіант Лікування Цукрового Діабету 2-Го Типу

COVID-19-associated euglycemic diabetic ketoacidosis in a patient with type 2 diabetes on SGLT2 inhibitor: a case report

Use of continuous glucose monitoring to improve glycemic management: A clinician's guide

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