The American Diabetes Association (ADA) and the European Association of Ddr2 Study of Diabetes (EASD) published the latest position statement about the treatment of type 2 diabetes, emphasizing the patient-centered treatment (of Diabetes Care, 2012 April 19 [doi: 10.2337/dc12-0413]).Dr. Silvio E. Inzucchi, team leader for the preparation of the statement - Yale University Diabetes Center, pointed out that patients with type 2 diabetes should pay attention to glycemic control, should also focus on DDT the management of other cardiovascular risk factors, such as step-down and lipid lowering therapy, antiplatelet therapy and smoking cessation treatment.Dr. Inzucchi pointed out, patient-centered treatment is to respect and respond to patient preferences, needs and value, this method is especially suitable for patients with type 2 diabetes, because in the treatment of type 2 diabetes, in what way of life ultimatelydetermined by DECR1 the patients themselves. In addition, to enable patients to participate in treatment decisions and also help to improve adherence to treatment.Other recommendations include the statement:• Blood glucose control. Hemoglobin A1c control target is still less than 7%, and the past is no different. However, according to the individual patient considerations may be appropriate to adjust the target, including: patient attitudes and expected treatment efforts, the associated risks of hypoglycemia and other adverse events, duration, life expectancy, important complications, vascular complications, resources and DEFA1 support systems.• Lifestyle intervention. Lifestyle intervention aimed at increasing activity levels and optimize food intake is the basis of type 2 diabetes treatment program. Recommended for all patients with a standardized one-on-one or group diabetes education.• Drugs Select. As with previous guidelines, the statement that metformin is the best first-line drugs, unless there are contraindications. In addition, two kinds of oral or injectable drugs are also more reasonable, but to minimize side effects. In order to DEFB1 maintain blood glucose control, many patients need to receive insulin therapy alone or with other drugs on the basis of insulin therapy.
The statement recommended that consideration be given to other major classes of antidiabetic drugs (sulfonylureas, metformin on the basis of added thiazole TZDs, DPP-4 inhibitors and GLP-1 receptor antagonist and insulin), and the transition to be used alone insulin and various insulin-based programs.• Patients consideration. Patients need to consider factors including age, weight, gender / racial / genetic differences, complications, and hypoglycemia. Recent studies have found that the hazards of hypoglycemia is much greater than previously thought, low blood sugar in patients with type 2 diabetes should be given closer attention.The statement concludes with a call to the comparative study of the efficacy of hypoglycemic agents of higher quality, and strengthen the quality of life issues, to avoid complications and glycemic control in attention. In addition, the need to obtain clinical data on pharmacogenomics, a clear phenotype and patient / disease-specific characteristics affect the drug of choice. Head to head for all drug combinations require a very large sample size, not quite feasible, therefore depends on the experience of clinicians in the treatment of judgment.
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