53
views
0
recommends
+1 Recommend
0 collections
    0
    shares
      • Record: found
      • Abstract: found
      • Article: not found

      Management of Hyperglycemia in Type 2 Diabetes, 2018. A Consensus Report by the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD)

      review-article

      Read this article at

      ScienceOpenPublisherPMC
      Bookmark
          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

          Abstract

          The American Diabetes Association and the European Association for the Study of Diabetes convened a panel to update the prior position statements, published in 2012 and 2015, on the management of type 2 diabetes in adults. A systematic evaluation of the literature since 2014 informed new recommendations. These include additional focus on lifestyle management and diabetes self-management education and support. For those with obesity, efforts targeting weight loss, including lifestyle, medication, and surgical interventions, are recommended. With regards to medication management, for patients with clinical cardiovascular disease, a sodium–glucose cotransporter 2 (SGLT2) inhibitor or a glucagon-like peptide 1 (GLP-1) receptor agonist with proven cardiovascular benefit is recommended. For patients with chronic kidney disease or clinical heart failure and atherosclerotic cardiovascular disease, an SGLT2 inhibitor with proven benefit is recommended. GLP-1 receptor agonists are generally recommended as the first injectable medication.

          Related collections

          Most cited references155

          • Record: found
          • Abstract: found
          • Article: not found

          Effects of Once-Weekly Exenatide on Cardiovascular Outcomes in Type 2 Diabetes.

          The cardiovascular effects of adding once-weekly treatment with exenatide to usual care in patients with type 2 diabetes are unknown.
            Bookmark
            • Record: found
            • Abstract: not found
            • Article: not found

            Thiazolidinediones

              Bookmark
              • Record: found
              • Abstract: found
              • Article: not found

              Effects of exercise on glycemic control and body mass in type 2 diabetes mellitus: a meta-analysis of controlled clinical trials.

              Exercise is widely perceived to be beneficial for glycemic control and weight loss in patients with type 2 diabetes. However, clinical trials on the effects of exercise in patients with type 2 diabetes have had small sample sizes and conflicting results. To systematically review and quantify the effect of exercise on glycosylated hemoglobin (HbA(1c)) and body mass in patients with type 2 diabetes. Database searches of MEDLINE, EMBASE, Sport Discuss, Health Star, Dissertation Abstracts, and the Cochrane Controlled Trials Register for the period up to and including December 2000. Additional data sources included bibliographies of textbooks and articles identified by the database searches. We selected studies that evaluated the effects of exercise interventions (duration >/=8 weeks) in adults with type 2 diabetes. Fourteen (11 randomized and 3 nonrandomized) controlled trials were included. Studies that included drug cointerventions were excluded. Two reviewers independently extracted baseline and postintervention means and SDs for the intervention and control groups. The characteristics of the exercise interventions and the methodological quality of the trials were also extracted. Twelve aerobic training studies (mean [SD], 3.4 [0.9] times/week for 18 [15] weeks) and 2 resistance training studies (mean [SD], 10 [0.7] exercises, 2.5 [0.7] sets, 13 [0.7] repetitions, 2.5 [0.4] times/week for 15 [10] weeks) were included in the analyses. The weighted mean postintervention HbA(1c) was lower in the exercise groups compared with the control groups (7.65% vs 8.31%; weighted mean difference, -0.66%; P<.001). The difference in postintervention body mass between exercise groups and control groups was not significant (83.02 kg vs 82.48 kg; weighted mean difference, 0.54; P =.76). Exercise training reduces HbA(1c) by an amount that should decrease the risk of diabetic complications, but no significantly greater change in body mass was found when exercise groups were compared with control groups.
                Bookmark

                Author and article information

                Journal
                Diabetes Care
                Diabetes Care
                diacare
                dcare
                Diabetes Care
                Diabetes Care
                American Diabetes Association
                0149-5992
                1935-5548
                December 2018
                5 October 2018
                : 41
                : 12
                : 2669-2701
                Affiliations
                [1] 1Diabetes Research Centre, University of Leicester, Leicester, U.K.
                [2] 2Leicester Diabetes Centre, Leicester General Hospital, Leicester, U.K.
                [3] 3Department of Medicine, Duke University School of Medicine, Durham, NC
                [4] 4National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD
                [5] 5Department of Medicine, Yale School of Medicine, New Haven, CT
                [6] 6Clinical and Experimental Endocrinology, UZ Gasthuisberg, KU Leuven, Leuven, Belgium
                [7] 7Department of Internal Medicine, Catholic University, Rome, Italy
                [8] 8Diabetes and Nutritional Sciences, King’s College London, London, U.K.
                [9] 9Steno Diabetes Center Copenhagen, Gentofte, Denmark
                [10] 10University of Copenhagen, Copenhagen, Denmark
                [11] 11Second Medical Department, Aristotle University Thessaloniki, Thessaloniki, Greece
                [12] 12Department of Medicine and Diabetes Unit, Massachusetts General Hospital, Boston, MA
                [13] 13Harvard Medical School, Boston, MA
                [14] 14Department of Medicine, University of North Carolina School of Medicine, Chapel Hill, NC
                Author notes
                Corresponding author: John B. Buse, jbuse@ 123456med.unc.edu .
                Article
                0033
                10.2337/dci18-0033
                6245208
                30291106
                7ddb74a8-72d3-4e87-8278-196734b4a4dd
                © 2018 American Diabetes Association and European Association for the Study of Diabetes.

                Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered. More information is available at http://www.diabetesjournals.org/content/license.

                Page count
                Pages: 33
                Product
                Categories
                Consensus Report

                Endocrinology & Diabetes
                Endocrinology & Diabetes

                Comments

                Comment on this article