Del Prato S, Felton A-M, Munro N, Nesto R, Zimmet P, Zinman B
University of Pisa, Italy.
Int J Clin Pract. 2005 Nov;59(11):1345-55. doi: 10.1111/j.1742-1241.2005.00674.x.
Despite increasingly stringent clinical practice guidelines for glycaemic control, the implementation of recommendations has been disappointing, with over 60% of patients not reaching recommended glycaemic goals. As a result, current management of glycaemia falls significantly short of accepted treatment goals. The Global Partnership for Effective Diabetes Management has identified a number of major barriers that can prevent individuals from achieving their glycaemic targets. This article proposes 10 key practical recommendations to aid healthcare providers in overcoming these barriers and to enable a greater proportion of patients to achieve glycaemic goals. These include advice on targeting the underlying pathophysiology of type 2 diabetes, treating early and effectively with combination therapies, adopting a holistic, multidisciplinary approach and improving patient understanding of type 2 diabetes. Implementation of these recommendations should reduce the risk of diabetes-related complications, improve patient quality of life and impact more effectively on the increasing healthcare cost related to diabetes.
尽管血糖控制的临床实践指南日益严格,但这些建议的实施情况却不尽如人意,超过60%的患者未达到推荐的血糖目标。因此,目前的血糖管理远远达不到公认的治疗目标。全球有效糖尿病管理伙伴关系已经确定了一些可能阻碍个人实现血糖目标的主要障碍。本文提出了10条关键的实用建议,以帮助医疗保健提供者克服这些障碍,并使更多患者能够实现血糖目标。这些建议包括针对2型糖尿病潜在病理生理学的建议、采用联合疗法进行早期有效治疗、采取整体的多学科方法以及提高患者对2型糖尿病的认识。实施这些建议应能降低糖尿病相关并发症的风险,提高患者生活质量,并更有效地影响与糖尿病相关的不断增加的医疗成本。