Document on a comprehensive approach to type 2 diabetes mellitus

Endocrinol Diabetes Nutr (Engl Ed). 2019 Aug-Sep;66(7):443-458. doi: 10.1016/j.endinu.2018.10.010. Epub 2019 Feb 28.
[Article in English, Spanish]

Abstract

Objective: Treatment of type 2 diabetes mellitus (T2DM) is complex and is intended to decrease morbidity and mortality. Management should therefore include adequate diabetes education, lifestyle changes, drug treatment to achieve early blood glucose control and reduction of cardiovascular (CV) risk factors, early detection and treatment of complications, and assessment of associated comorbidities. The objective was to prepare a document including all aspects required for a comprehensive approach to T2DM.

Participants: Members of the Diabetes Mellitus Working Group of the Spanish Society of Endocrinology.

Methods: The available evidence regarding each aspect of diabetes management (blood glucose control goals, diet and exercise, drug treatment, risk factor management and control, detection of complications, and management of frail patients) was reviewed. Recommendations were formulated based on the grades of evidence stated in the 2018 Standards of Medical Care in Diabetes. Recommendations were discussed and agreed by the working group members.

Conclusions: This document is intended to provide evidence-based practical recommendations for comprehensive management of T2DM by clinical endocrinologists.

Keywords: Abordaje integral; Comprehensive management; Diabetes tipo 2; Drug treatment; Lifestyle changes; Modificaciones de estilo de vida; Tratamiento farmacológico; Type 2 diabetes mellitus.

Publication types

  • Practice Guideline

MeSH terms

  • Algorithms
  • Cardiovascular Diseases / epidemiology
  • Cardiovascular Diseases / etiology
  • Cardiovascular Diseases / prevention & control
  • Clinical Trials as Topic
  • Combined Modality Therapy
  • Comorbidity
  • Cost-Benefit Analysis
  • Diabetes Complications / prevention & control
  • Diabetes Mellitus, Type 2 / therapy*
  • Diet, Diabetic
  • Disease Management
  • Dyslipidemias / epidemiology
  • Dyslipidemias / therapy
  • Evidence-Based Medicine
  • Exercise
  • Glycated Hemoglobin / analysis
  • Humans
  • Hypertension / epidemiology
  • Hypertension / therapy
  • Hypoglycemic Agents / economics
  • Hypoglycemic Agents / therapeutic use
  • Insulin / administration & dosage
  • Insulin / therapeutic use
  • Life Style
  • Non-alcoholic Fatty Liver Disease / diagnosis
  • Non-alcoholic Fatty Liver Disease / epidemiology
  • Patient Education as Topic
  • Sleep Apnea Syndromes / epidemiology

Substances

  • Glycated Hemoglobin A
  • Hypoglycemic Agents
  • Insulin