Main Line Health, Wynnewood, PA, USA.
University of Pennsylvania, Philadelphia, PA, USA.
BMC Med. 2024 Sep 4;22(1):356. doi: 10.1186/s12916-024-03518-5.
This review seeks to address major gaps and delays between our rapidly evolving body of knowledge on type 2 diabetes and its translation into real-world practice. Through updated and improved best practices informed by recent evidence and described herein, we stand to better attain A1c targets, help preserve beta cell integrity and moderate glycemic variability, minimize treatment-emergent hypoglycemia, circumvent prescribing to "treatment failure," and prevent long-term complications. The first topic addressed in this review concerns updates in the 2023 and 2024 diabetes treatment guidelines for which further elaboration can help facilitate integration into routine care. The second concerns advances in diabetes research that have not yet found their way into guidelines, though they are endorsed by strong evidence and are ready for real-world use in appropriate patients. The final theme addresses lingering misconceptions about the underpinnings of type 2 diabetes-fundamental fallacies that continue to be asserted in the textbooks and continuing medical education upon which physicians build their approaches. A corrected and up-to-date understanding of the disease state is essential for practitioners to both conceptually and translationally manage initial onset through late-stage type 2 diabetes.
本综述旨在解决我们在 2 型糖尿病知识快速发展与其向实际应用转化之间的主要差距和延迟。通过更新和改进由最新证据提供信息并在此描述的最佳实践，我们有望更好地实现 A1c 目标，帮助保护β细胞完整性和适度的血糖变异性，最大限度地减少治疗中出现的低血糖，避免“治疗失败”的处方，并预防长期并发症。本综述首先讨论了 2023 年和 2024 年糖尿病治疗指南的更新，这些更新的内容进一步阐述有助于将其纳入常规护理。其次，讨论了尚未纳入指南但已得到强有力证据支持并已准备好在适当患者中实际应用的糖尿病研究进展。最后一个主题涉及对 2 型糖尿病基础的持久误解——这些误解仍然在教科书和继续医学教育中被断言，而医生正是基于这些内容来制定治疗方法。为了在概念上和翻译上管理 2 型糖尿病的初始发作和晚期阶段，医生必须正确理解和掌握当前的疾病状态。
