Management of Type 2 Diabetes in 2017 Getting to Goal

被引：125

作者：

Reusch, Jane E. B. ^{[1
,2
]}

Manson, JoAnn E. ^{[3
,4
,5
]}

机构：

[1] Univ Colorado, Anschutz Med Ctr, Ctr Womens Hlth Res, Denver, CO 80202 USA

[2] Denver VA Med Ctr, Denver, CO USA

[3] Brigham & Womens Hosp, Dept Med, 75 Francis St, Boston, MA 02115 USA

[4] Harvard Med Sch, Boston, MA USA

[5] Harvard TH Chan Sch Publ Hlth, Dept Epidemiol, Boston, MA USA

来源：

JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION | 2017年 / 317卷 / 10期

关键词：

CARDIOVASCULAR OUTCOMES; ASSOCIATION; STATEMENT;

D O I：

10.1001/jama.2017.0241

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Patient-centered diabetes management can be accomplished with lifestyle modification and combination therapy.Metformin is an optimal first-line agent; newer GLP1 and SGLT2 agents have efficacy for glucose lowering coupled withweight loss and potential cardiovascular risk reduction; and insulin therapy is generally safe and effectivefor patients not controlled with noninsulin agents. In younger, healthy, newly diagnosed patients, a hemoglobinA1c level less than 7%should be the goal; in older individuals with comorbidities, less stringent goals with a focus on safety and avoidance of hypoglycemia are critical. Antihyperglycemic therapy shouldbecombinedwith evidence-based treatment of cholesterolandblood pressure for cardiovascular risk reduction. Although the cardiovascular benefits of SGLT2 and GLP1 agents merit consideration, these medications are not replacements for statin therapy or blood pressure management for reducing the risk of cardiovascular disease. Copyright 2017 American Medical Association. All rights reserved.

引用

页码：1015 / 1016

页数：2

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