Guía de práctica clínica para la prevención, diagnóstico, tratamiento y seguimiento de la diabetes mellitus tipo 2 en la población mayor de 18 años

M, Pablo Aschner; Muñoz, Óscar; Girón, Diana; García, Olga Milena; Fernández-Ávila, Daniel G.; Casas, Luz Ángela; Bohórquez, Luisa Fernanda; T, Clara María Arango; Carvajal, Liliana; Ramírez, Doris; Sarmiento, Juan Guillermo; Colon, Cristian Alejandro; G, Néstor Fabián Correa; R, Pilar Alarcón; S, Álvaro Andrés Bustamante

doi:10.25100/cm.v47i2.2207

Cited by 48 publications

(46 citation statements)

References 82 publications

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“…Considering the workforce and resources needed to screen the millions of persons across the region who are at risk of diabetes or have the disease and are not aware, experts have proposed diabetes predictive models requiring specific easily obtained clinical data points that could be readily used in primary care settings [192][193][194]. Also, the Finnish Diabetes Risk Score (FINDRISC) has been proposed, tested, or modified to screen and identify individuals at high risk of developing diabetes in Latin America [195][196][197][198][199]. Point-of-care tests for HbA1c and urine microalbumin have also been proposed as alternatives to identify persons with "undiagnosed diabetes" and/or those at risk of chronic kidney disease (CKD) in low-resource and remote settings in LatAm [200][201][202][203].…”

Section: Diabetes Awarenessmentioning

confidence: 99%

Current State of Diabetes Mellitus Prevalence, Awareness, Treatment, and Control in Latin America: Challenges and Innovative Solutions to Improve Health Outcomes Across the Continent

et al. 2020

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Purpose of Review Latin America is the scenario of great inequalities where about 32 million human beings live with diabetes. Through this review, we aimed at describing the current state of the prevalence, awareness, treatment, and control of diabetes mellitus and completion of selected guidelines of care across Latin America and identify opportunities to advance research that promotes better health outcomes. Recent Findings The prevalence of diabetes mellitus has been consistently increasing across the region, with some variation: higher prevalence in Mexico, Haiti, and Puerto Rico and lower in Colombia, Ecuador, Dominican Republic, Peru, and Uruguay. Prevalence assessment methods vary, and potentially underestimating the real number of persons with diabetes. Diabetes unawareness varies widely, with up to 50% of persons with diabetes who do not know they may have the disease. Glycemic, blood pressure, and LDL-C control and completion of guidelines to prevent microvascular complications are not consistently assessed across studies, and the achievement of control goals is suboptimal. On the other hand, multiple interventions, point-of-care/rapid assessment tools, and alternative models of health care delivery have been proposed and tested throughout Latin America. Summary The prevalence of diabetes mellitus continues to rise across Latin America, and the number of those with the disease may be underestimated. However, some local governments are embedding more comprehensive diabetes assessments in their local national surveys. Clinicians and public health advocates in the region have proposed and initiated various multi-level interventions to address this enormous challenge in the region. Keywords Latin America. Diabetes prevalence. Diabetes treatment. Control. Diabetes complications. Interventions. Health care This article is part of the Topical Collection on Diabetes Epidemiology

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Section: Diabetes Awarenessmentioning

confidence: 99%

Current State of Diabetes Mellitus Prevalence, Awareness, Treatment, and Control in Latin America: Challenges and Innovative Solutions to Improve Health Outcomes Across the Continent

et al. 2020

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“…For the present analysis risk stratification was performed according to the presence of type 2 diabetes (diabetics) compared to non-diabetics following the guidelines of the international diabetes federation [ 13 ]. Diabetes mellitus was defined as HbA1c ≥ 6.5% (48 mmol/mol) or fasting plasma glucose level ≥ 7.0 mmol/L (≥126 mg/dl) or 2-h post-load plasma glucose level ≥ 11.1 mmol/L (≥200 mg/dL) [ 13 , 14 ]. Patients with previously diagnosed and currently treated type 2 diabetes were included.…”

Section: Methodsmentioning

confidence: 99%

Type 2 diabetes is independently associated with all-cause mortality secondary to ventricular tachyarrhythmias

Weidner

Behnes

Schupp

et al. 2018

Cardiovasc Diabetol

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ObjectivesThe study sought to assess the prognostic impact of type 2 diabetes in patients presenting with ventricular tachyarrhythmias on admission.BackgroundData regarding the prognostic outcome of diabetics presenting with ventricular tachyarrhythmias is limited.MethodsA large retrospective registry was used including all consecutive patients presenting with ventricular tachycardia (VT) and fibrillation (VF) on admission from 2002 to 2016. Patients with type 2 diabetes (diabetics) were compared to non-diabetics applying multivariable Cox regression models and propensity-score matching for evaluation of the primary prognostic endpoint of long-term all-cause mortality at 2 years. Secondary prognostic endpoints were cardiac death at 24 h, in-hospital death at index, all-cause mortality at 30 days, all-cause mortality in patients surviving index hospitalization at 2 years (i.e. “after discharge”) and rehospitalization due to recurrent ventricular tachyarrhythmias at 2 years.ResultsIn 2411 unmatched high-risk patients with ventricular tachyarrhythmias, diabetes was present in 25% compared to non-diabetics (75%). Rates of VT (57% vs. 56%) and VF (43% vs. 44%) were comparable in both groups. Multivariable Cox regression models revealed diabetics associated with the primary endpoint of long-term all-cause mortality at 2 years (HR = 1.513; p = 0.001), which was still proven after propensity score matching (46% vs. 33%, log rank p = 0.001; HR = 1.525; p = 0.001). The rates of secondary endpoints were higher for in-hospital death at index, all-cause mortality at 30 days, as well as after discharge, but not for cardiac death at 24 h or rehospitalization due to recurrent ventricular tachyarrhythmias.ConclusionPresence of type 2 diabetes is independently associated with an increase of all-cause mortality in patients presenting with ventricular tachyarrhythmias on admission.

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“…After removal of duplicates, we assessed 11 264 unique citations, of which 124 were retrieved for full-text review; 17 guidelines proved eligible ( Fig. 1) [8,9,[18][19][20][21][22][23][24][25][26][27][28][29][30][31][32]. Table 1 presents the characteristics of all eligible guidelines.…”

Section: Identification and Characteristics Of Guidelinesmentioning

confidence: 99%

Management of type 2 diabetes using non‐insulin glucose‐lowering therapies: a critical appraisal of clinical practice guidelines with the AGREE II instrument

et al. 2020

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Aim Type 2 diabetes is a major global epidemic affecting over 400 million people worldwide. The objective of this systematic review was to provide an overview of recommendations from clinical practice guidelines (guidelines) addressing non‐insulin based pharmacological management of among non‐pregnant adults in an outpatient setting, and critically appraise their methodological development. Methods We systematically searched MEDLINE and Embase databases, for relevant guidelines using the Ovid interface. We scanned the bibliographies of all eligible guidelines for additional relevant citations. Teams of two reviewers, independently and in duplicate, screened titles and abstracts and potentially eligible full text reports to determine eligibility and appraised the reporting quality of guidelines using the Advancing Guideline Development, Reporting and Evaluation in Health Care instrument II (AGREE II) instrument. Results Our search yielded 11264 unique citations, of which 124 were retrieved for full‐text review; 17 guidelines proved eligible. The highest scoring AGREE domain was ‘clarity of presentation’ (66%; range 7–92%), followed by ‘scope and purpose’ (58%; range 25–92%), ‘editorial independence’ (55%; range 0–91%), ‘stakeholder involvement’ (45%; range 11–90%) and ‘rigour of development’ (43%; range 4–92%). The poorest domain was ‘applicability’ (37%; range 6–84%). The guidelines authored by the World Health Organization group achieved the highest AGREE overall score. Conclusions Most of the guidelines provided recommendations with a local jurisdictional focus and showed significant variation in the quality. Nevertheless, only a small number of those scored well overall.

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Guía de práctica clínica para la prevención, diagnóstico, tratamiento y seguimiento de la diabetes mellitus tipo 2 en la población mayor de 18 años

Cited by 48 publications

References 82 publications

Current State of Diabetes Mellitus Prevalence, Awareness, Treatment, and Control in Latin America: Challenges and Innovative Solutions to Improve Health Outcomes Across the Continent

Current State of Diabetes Mellitus Prevalence, Awareness, Treatment, and Control in Latin America: Challenges and Innovative Solutions to Improve Health Outcomes Across the Continent

Type 2 diabetes is independently associated with all-cause mortality secondary to ventricular tachyarrhythmias

Management of type 2 diabetes using non‐insulin glucose‐lowering therapies: a critical appraisal of clinical practice guidelines with the AGREE II instrument

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