Sheikh Omar, Nashawi Mouhamed, Battisha Ayman, Chilton Robert
Division of Medicine-Cardiology, UT Health San Antonio, San Antonio, Texas.
Department of Internal Medicine, University of Massachusetts Medical School-Bay State, Springfield, Massachusetts, USA.
Cardiovasc Endocrinol Metab. 2020 May 15;9(2):36-41. doi: 10.1097/XCE.0000000000000192. eCollection 2020 Jun.
Primary care physicians in the USA serve the critical role of first contact for undiagnosed or mismanaged pathologies as well as providers of continuous care in multiple communities. Their scope of practice is broad from medication reconciliation to coordinating specialty care and even performing office procedures. Primary care physicians in the USA commonly encounter patients with diabetes and associated comorbidities related to prolonged insulin resistance. Mainly these include heart failure exacerbation or major adverse cardiovascular events. The demanding roles primary care physicians serve may render these providers encumbered to navigate through long, verbose and dynamic guidelines related to managing diabetes and cardiac diabetology sequelae. Our aim is to compose current, prominent evidence-based points from American medical societies such as the American College of Cardiology/American Heart Association and the American Diabetes Association central to lifestyle modifications, antiplatelet therapy, anti-hyperglycemic and SGLT2-inhibitor utilization, hypertension, dyslipidemia, and heart failure screening in a way that is both succinct and valuable to primary care physicians.
美国的初级保健医生在未确诊或管理不善的病症的首次接触以及多个社区的持续护理提供者方面发挥着关键作用。他们的执业范围很广,从药物重整到协调专科护理,甚至进行门诊手术。美国的初级保健医生经常会遇到患有糖尿病以及与长期胰岛素抵抗相关的合并症的患者。主要包括心力衰竭加重或重大心血管不良事件。初级保健医生所承担的艰巨职责可能使这些医疗服务提供者在遵循与糖尿病管理和糖尿病心脏病后遗症相关的冗长、繁琐且不断变化的指南时感到负担沉重。我们的目标是以简洁且对初级保健医生有价值的方式,整理美国心脏病学会/美国心脏协会和美国糖尿病协会等美国医学协会关于生活方式改变、抗血小板治疗、降糖和SGLT2抑制剂使用、高血压、血脂异常以及心力衰竭筛查的当前突出的循证要点。