13 research outputs found
Important updates on the management of inpatient hyperglycemia: Practical implications for pharmacists: Introduction
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Statement by an American Association of Clinical Endocrinologists/American College of Endocrinology consensus panel on type 2 diabetes mellitus: an algorithm for glycemic control
This report presents an algorithm to assist primary care physicians, endocrinologists, and others in the management of adult, nonpregnant patients with type 2 diabetes mellitus. In order to minimize the risk of diabetes-related complications, the goal of therapy is to achieve a hemoglobin A1c (A1C) of 6.5% or less, with recognition of the need for individualization to minimize the risks of hypoglycemia. We provide therapeutic pathways stratified on the basis of current levels of A1C, whether the patient is receiving treatment or is drug naïve. We consider monotherapy, dual therapy, and triple therapy, including 8 major classes of medications (biguanides, dipeptidyl-peptidase-4 inhibitors, incretin mimetics, thiazolidinediones, alpha-glucosidase inhibitors, sulfonylureas, meglitinides, and bile acid sequestrants) and insulin therapy (basal, premixed, and multiple daily injections), with or without orally administered medications. We prioritize choices of medications according to safety, risk of hypoglycemia, efficacy, simplicity, anticipated degree of patient adherence, and cost of medications. We recommend only combinations of medications approved by the US Food and Drug Administration that provide complementary mechanisms of action. It is essential to monitor therapy with A1C and self-monitoring of blood glucose and to adjust or advance therapy frequently (every 2 to 3 months) if the appropriate goal for each patient has not been achieved. We provide a flow-chart and table summarizing the major considerations. This algorithm represents a consensus of 14 highly experienced clinicians, clinical researchers, practitioners, and academicians and is based on the American Association of Clinical Endocrinologists/American College of Endocrinology Diabetes Guidelines and the recent medical literature
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Diagnosis and management of prediabetes in the continuum of hyperglycemia: when do the risks of diabetes begin? A consensus statement from the American College of Endocrinology and the American Association of Clinical Endocrinologists
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AMERICAN ASSOCIATION OF CLINICAL ENDOCRINOLOGISTS/AMERICAN COLLEGE OF ENDOCRINOLOGY STATEMENT ON THE USE OF HEMOGLOBIN A1c FOR THE DIAGNOSIS OF DIABETES
The American Association of Clinical Endocrinologists (AACE) and the American College of Endocrinology (ACE) have evaluated the role of hemoglobin A1c (A1C) for the diagnosis of type 2 diabetes. The American Diabetes Association 2010 Clinical Practice Recommendations endorse the use of A1C of 6.5% or higher as the primary criterion for the diagnosis of diabetes. Such testing does not require the patient to be fasting, can be done at any time that a clinical visit is scheduled, is simpler to perform than the 2-hour oral glucose tolerance test, and is less dependent on the patient's health status at the time a blood sample is obtained. AACE/ACE do not endorse A1C criteria for prediabetes or for those patients at risk for diabetes. AACE/ACE do support an A1C of 5.5% to 6.4% as a screening test for prediabetes if it leads to measurement of a fasting glucose level or performance of a glucose tolerance test for diagnosis