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)
Контроль гипергликемии при сахарном диабете 2 типа, 2018: Консенсусный отчет Американской диабетической ассоциации (ADA) и Европейской ассоциации по изучению диабета (EASD)
2018-10-05
SCID: 54.1/h3pzbwc6
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GLP-1 receptor agonistSGLT2 inhibitorType 2 diabetesmajor adverse cardiovascular events (MACE)
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Abstract (AI)
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.
Key Findings
1
GLP-1 receptor agonists can be considered for patients with type 2 diabetes without established CVD if they have specific indicators of high cardiovascular risk.
2
SGLT2 inhibitors are recommended for patients with type 2 diabetes and CKD (eGFR 30 to ≤60 mL·min⁻¹·1.73 m⁻² or UACR >30 mg/g, particularly >300 mg/g) to prevent CKD progression, hHF, MACE, and cardiovascular death.
3
SGLT2 inhibitors are recommended for patients with type 2 diabetes and heart failure, especially with reduced ejection fraction, to reduce hHF, MACE, and cardiovascular death.
4
Treating high-risk individuals with a GLP-1 receptor agonist or SGLT2 inhibitor to reduce MACE, hHF, cardiovascular death, or CKD progression should be considered regardless of baseline HbA1c or individualized HbA1c target.
Research Object
Management of hyperglycemia in type 2 diabetes (clinical treatment strategies for glycemic control and related comorbidity risk)
Research Subject
Recommendations on use of GLP-1 receptor agonists and SGLT2 inhibitors to reduce major adverse cardiovascular events, hospitalization for heart failure, cardiovascular death, and chronic kidney disease progression, including patient selection criteria independent of baseline or individualized HbA1c
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2018-10-05
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