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- September 6, 2010 |
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| Presentation |
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"The importance of achieving glycemic control"Prof. Stephan Matthaei (biography)
English - 2008-05-17 - 32 minutes
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Summary :
The United Kingdom Prospective Diabetes Study (UKPDS) showed in type 2 diabetic patients that a fall in A1c of one percent results in a reduction in the relative risk of complications (1), however glycaemic targets are still not being met in large numbers of patients. This could be due to continuation of the traditional step-wise approach to therapy in which long delays can occur between the first measurement of an A1c above 8% on monotherapy and a switch or addition in therapy (2). Prof. Matthaei presents studies on the efficacy and safety of combination therapy in type 2 diabetes.
According to the consensus statement from the American Diabetes Association and the European Association for the Study of Diabetes, the goal is to achieve and maintain glycemic levels as close to the nondiabetic range as possible, and to change interventions at as rapid a pace as titration of medications allows. The guidelines and treatment algorithm presented emphasise “..initial therapy with lifestyle intervention and metformin; rapid addition of medications, and transition to new regimens, when target glycemic goals are not achieved or sustained; and early addition of insulin therapy in patients who do not meet target goals” (3). Prof. Matthaei also discusses initiatives from the Global Partnership for Effective Diabetes Management; the recently published German guidelines for therapy of type 2 diabetes (4); and results from a U.S. prediction model showing the effects of treat-to-target on complications and costs over 30 years.
Copyright © 2008 E-MedHosting.com Inc.
Learning objectives :
After viewing this presentation the participant will be able to discuss:
- Effects of a fall in A1c on the relative risk of complications in T2DM
- U.S. and German guidelines for therapy of T2DM
- Efficacy and safety of combination therapies
- Predicted health-economic benefits of treating to target in T2DM
Bibliographic references :
1. Stratton IM, Adler AI, Neil HA, Matthews DR, Manley SE, Cull CA, Hadden D, Turner RC, Holman RR. Association of glycaemia with macrovascular and microvascular complications of type 2 diabetes (UKPDS 35): prospective observational study BMJ 2000;321:405-412.
2. Brown J et al., Diabetes 2003; 52(Suppl 1):A61-A62.
3. Nathan DM, Buse JB, Davidson MB, Heine RJ, Holman RR, Sherwin R, Zinman B. Management of Hyperglycemia in Type 2 Diabetes: A Consensus Algorithm for the Initiation and Adjustment of Therapy: A consensus statement from the American Diabetes Association and the European Association for the Study of Diabetes Diabetes Care 29:1963-1972, 2006.
4. http://www.deutsche-diabetes-gesellschaft.de/
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