Holleman F, de Vries J H, Hoekstra J B L
Academisch Medisch Centrum/Universiteit van Amsterdam, Afd. Inwendige Geneeskunde, Meibergdreef 9, 1105, AZ Amsterdam.
Ned Tijdschr Geneeskd. 2006 Oct 14;150(41):2235-7.
The revised guideline 'Diabetes mellitus type 2' contains several improvements. The HbA1C target level has been lowered to 7% or less. The universal first step in oral therapy has become metformin. The target level for the treatment of hypertension is now a systolic pressure below 140 mmHg. Statins should be prescribed to almost every patient. Finally, ACE-inhibitors are now suggested for all patients with microalbuminuria and hypertension. Some choices made in the present guideline are not evidence-based, e.g. the advice to prescribe pioglitazone to patients with both a body mass index above 27 kg/m2 and cardiovascular disease, but without heart failure. Still, in general, the updated guideline is an important document which has been greatly improved in comparison to the former one.
修订后的《2型糖尿病指南》有多项改进。糖化血红蛋白（HbA1C）目标水平已降至7%或更低。口服治疗的通用第一步已变为二甲双胍。高血压治疗的目标水平现在是收缩压低于140毫米汞柱。几乎应给每位患者开他汀类药物。最后，现在建议所有微量白蛋白尿和高血压患者使用血管紧张素转换酶抑制剂（ACE抑制剂）。本指南中的一些选择并非基于证据，例如建议给体重指数高于27千克/平方米且患有心血管疾病但无心力衰竭的患者开吡格列酮。尽管如此，总体而言，更新后的指南是一份重要文件，与之前的指南相比有了很大改进。
