Mediavilla Bravo José Javier
Medicina de Familia, Centro de Salud Burgos Rural, Burgos, España.
Semergen. 2014 Sep;40 Suppl 4:11-8. doi: 10.1016/S1138-3593(14)74392-8.
In the last few years, the publication of new studies in diabetes, together with the development of new classes of blood glucose-lowering medications, have led to updates of the most prestigious clinical practice guidelines for the treatment of diabetes. Thus, a consensus statement from the American Diabetes Association and the European Association for the Study of Diabetes on the management of hyperglycemia in type 2 diabetes was published in April 2012. An update of one of the evidence-based guidelines issued by the Canadian Diabetes Association appeared in 2013 and this year, 2014, saw the publication of the consensus document of the redGDPS, whose guidelines are those most closely followed by primary care physicians in Spain. The three guidelines highlight the need for an individualized approach to type 2 diabetes mellitus, outlining both target glycemic goals and distinct treatment regimens based on patient characteristics, disease stage and the presence of comorbidities or complications. In the treatment of the disease, the three guidelines also stress the importance of considering patients' opinions and of recommending lifestyle modifications to achieve good disease control. Metformin is identified as the first-line drug, with the addition of other glucose-lowering agents if necessary.
在过去几年中，糖尿病领域新研究的发表以及新型降糖药物的研发，促使最具权威性的糖尿病治疗临床实践指南得到更新。因此，美国糖尿病协会和欧洲糖尿病研究协会于2012年4月发表了关于2型糖尿病高血糖管理的共识声明。加拿大糖尿病协会发布的一项循证指南于2013年进行了更新，而在今年，即2014年，西班牙初级保健医生最常遵循其指南的redGDPS共识文件得以发表。这三项指南都强调了对2型糖尿病采取个体化治疗方法的必要性，根据患者特征、疾病阶段以及合并症或并发症的情况，明确了血糖控制目标和不同的治疗方案。在该疾病的治疗中，这三项指南还强调了考虑患者意见以及推荐生活方式改变以实现良好疾病控制的重要性。二甲双胍被确定为一线药物，必要时可加用其他降糖药物。
