FRINK Linked Data Fragments server

Matches in SemOpenAlex for { <https://semopenalex.org/work/W4240794548> ?p ?o ?g. }

• W4240794548 endingPage "87" @default.
• W4240794548 startingPage "1" @default.
• W4240794548 abstract "Abbreviations:A1Chemoglobin A1cAACEAmerican Association of Clinical EndocrinologistsACCORDAction to Control Cardiovascular Risk in DiabetesACEangiotensin-converting enzymeADAAmerican Diabetes AssociationADVANCEAction in Diabetes and Vascular Disease: Preterax and Diamicron MR Controlled EvaluationAERalbumin excretion rateAPOBapolipoprotein BARBangiotensin II receptor blockerASCVDatherosclerotic cardiovascular diseaseBElbest evidence levelBMIbody mass indexCDCCenters for Disease Control and PreventionCDEcertified diabetes educatorCGMcontinuous glucose monitoringCKDchronic kidney diseaseCPAPcontinuous positive airway pressureCPGclinical practice guidelineCSIIcontinuous subcutaneous insulin infusionCVDcardiovascular diseaseDCCTDiabetes Control and ComplicationsDKAdiabetic ketoacidosisDMdiabetes mellitusDPPDiabetes Prevention ProgramDPP-4dipep-tidyl peptidase 4DSMEdiabetes self-management educationDSPNdistal symmetric polyneuropathyElevidence levelESRDend-stage renal diseaseFDAU.S. Food and Drug AdministrationFPGfasting plasma glucoseGDMgestational diabetes mellitusGFRglomerular filtration rateGIgastrointestinalGLP-1glucagon-like peptide 1HBVhepatitis B virusHDL-Chigh-density lipoprotein cholesterolHRhazard ratioICUintensive care unitIFGimpaired fasting glucoseIGTimpaired glucose toleranceISFinsulin sensitivity factorLDL-Clow-density lipoprotein cholesterolLDL-plow-density lipoprotein particlesLOOK AHEADLook Action for Health in DiabetesMDImultiple daily injectionsMNTmedical nutrition therapyNPHneutral protamine HagedornOGTToral glucose tolerance testOSAobstructive sleep apneaPGplasma glucosePOCpoint-of-carePPGpostprandial glucosePTHparathyroid hormoneQclinical questionRrecommendationRAASrenin-angiotensin-aldosterone systemRCTrandomized controlled trialSFNsmall-fiber neuropathySGLT2sodium glucose cotransporter 2SMBGself-monitoring of blood glucoseT1Dtype 1 diabetesT2Dtype 2 diabetesTZDthiazolidinedioneUKPDSUnited Kingdom Prospective Diabetes StudyVADTVeterans Affairs Diabetes Trial hemoglobin A1c American Association of Clinical Endocrinologists Action to Control Cardiovascular Risk in Diabetes angiotensin-converting enzyme American Diabetes Association Action in Diabetes and Vascular Disease: Preterax and Diamicron MR Controlled Evaluation albumin excretion rate apolipoprotein B angiotensin II receptor blocker atherosclerotic cardiovascular disease best evidence level body mass index Centers for Disease Control and Prevention certified diabetes educator continuous glucose monitoring chronic kidney disease continuous positive airway pressure clinical practice guideline continuous subcutaneous insulin infusion cardiovascular disease Diabetes Control and Complications diabetic ketoacidosis diabetes mellitus Diabetes Prevention Program dipep-tidyl peptidase 4 diabetes self-management education distal symmetric polyneuropathy evidence level end-stage renal disease U.S. Food and Drug Administration fasting plasma glucose gestational diabetes mellitus glomerular filtration rate gastrointestinal glucagon-like peptide 1 hepatitis B virus high-density lipoprotein cholesterol hazard ratio intensive care unit impaired fasting glucose impaired glucose tolerance insulin sensitivity factor low-density lipoprotein cholesterol low-density lipoprotein particles Look Action for Health in Diabetes multiple daily injections medical nutrition therapy neutral protamine Hagedorn oral glucose tolerance test obstructive sleep apnea plasma glucose point-of-care postprandial glucose parathyroid hormone clinical question recommendation renin-angiotensin-aldosterone system randomized controlled trial small-fiber neuropathy sodium glucose cotransporter 2 self-monitoring of blood glucose type 1 diabetes type 2 diabetes thiazolidinedione United Kingdom Prospective Diabetes Study Veterans Affairs Diabetes Trial These 2015 clinical practice guidelines (CPGs) for developing a diabetes mellitus (DM) comprehensive care plan are an update of the 2011 American Association of Clinical Endocrinologists (AACE) Medical Guidelines for Clinical Practice for Developing a Diabetes Mellitus Comprehensive Care Plan (1.Handelsman Y. Mechanick J.I. Blonde L. et al.American Association of Clinical Endocrinologists Medical Guidelines for Clinical Practice for developing a diabetes mellitus comprehensive care plan.Endocr Pract. 2011; 17 ([EL 4; NE]): 1-53Abstract Full Text Full Text PDF PubMed Google Scholar [EL 4; NE]). The mandate for this CPG is to provide a practical guide for comprehensive care that incorporates an integrated consideration of micro- and macrovascular risk (including cardiovascular risk factors such as lipids, hypertension, and coagulation) rather than an isolated approach focusing merely on glyce-mic control. In addition to topics covered in the 2011 CPG, this update offers new and expanded information on vaccinations; cancer risk; and management of obesity, sleep disorders, and depression among persons with DM, as well as medical management of commercial vehicle operators and others with occupations that put them at increased risks of obesity and DM or in which hypoglycemia might endanger other individuals. In addition, discussions of hypertension management, nephropathy management, hypoglycemia, and antihyperglycemic therapy have been substantially revised and updated. The 2015 treatment goals emphasize individualized targets for weight loss, glucose, lipid, and hypertension management. In addition, the 2015 Guidelines promote personalized management plans with a special focus on safety beyond efficacy. When a routine consultation is made for DM management, these new guidelines advocate taking a comprehensive approach and suggest that the clinician should move beyond a simple focus on glycemic control. This comprehensive approach is based on the evidence that although glycemic control parameters (hemoglobin A1c [A1C], postprandial glucose [PPG] excursions, fasting plasma glucose [FPG], glycemic variability) have an impact on the risk of microvascular complications and cardiovascular disease (CVD), mortality, and quality of life, other factors also affect clinical outcomes in persons with DM. The objectives of this CPG are to provide the following:•An education resource for the development of a comprehensive care plan for clinical endocrinologists and other clinicians who care for patients with DM.•An evidence-based resource addressing specific problems in DM care.•A document that can eventually be electronically implemented in clinical practices to assist with decision-making for patients with DM. To achieve these goals, this CPG includes an executive summary consisting of 67 clinical practice recommendations organized within 24 questions covering the spectrum of DM management. The recommendations provide brief, accurate answers to each question, and an extensively referenced appendix organized according to the same list of questions provides supporting evidence for each recommendation. The format is concise and does not attempt to present an encyclopedic citation of all pertinent primary references, which would create redundancy and overlap with other published CPGs and evidence-based reports related to DM. Therefore, although many highest evidence level (EL) studies—consisting of randomized controlled trials (RCTs) and meta-analyses of these trials (EL 1)—are cited in this CPG, in the interest of conciseness, there is also a deliberate, preferential, and frequent citation of derivative EL 4 publications that include many primary evidence citations (EL 1, EL 2, and EL 3). Thus, this CPG is not intended to serve as a DM textbook but rather to complement existing texts as well as other DM CPGs available in the literature including previously published AACE DM CPGs. The AACE Board of Directors mandated an update of the 2011 AACE DM CPG (1.Handelsman Y. Mechanick J.I. Blonde L. et al.American Association of Clinical Endocrinologists Medical Guidelines for Clinical Practice for developing a diabetes mellitus comprehensive care plan.Endocr Pract. 2011; 17 ([EL 4; NE]): 1-53Abstract Full Text Full Text PDF PubMed Google Scholar [EL 4; NE]), which expired in 2014. Selection of the cochairs, primary writers, and reviewers, as well as the logistics for creating this evidence-based CPG were conducted in strict adherence with the AACE Protocol for Standardized Production of Clinical Practice Guidelines—2010 and 2014 Updates (2.Mechanick J.I. Camacho P.M. Cobin R.H. et al.American Association of Clinical Endocrinologists Protocol for Standardized Production of Clinical Practice Guidelines--2010 update.Endocr Pract. 2010; 16 ([EL 4; CPG NE; see Fig. 1; Tables 1-4]): 270-283Abstract Full Text Full Text PDF PubMed Scopus (0) Google Scholar [EL 4; CPG NE; see Fig. 1; Table 1, Table 2, Table 3, Table 4]; 3.Mechanick J.I. Camacho P.M. Garber A.J. et al.American Association of Clinical Endocrinologists and American College of Endocrinology Protocol for Standardized Production of Clinical Practice Guidelines, Algorithms, and Checklists - 2014 Update and the AACe G4G Program.Endocr Pract. 2014; 20 ([EL 4; CPG NE; see Tables 1-4]): 692-702Abstract Full Text Full Text PDF PubMed Scopus (0) Google Scholar [EL 4; CPG NE; see Table 1, Table 2, Table 3, Table 4]).Table 12010 American Association of Clinical Endocrinologists protocol for production of Clinical practice guidelines—step i: Evidence RatingaAdapted from (1): Endocr Pract. 2010;16:270-283.numerical descriptor (evidence level)b1, strong evidence; 2, intermediate evidence; 3, weak evidence; and 4, no evidence.semantic descriptor (reference methodology)1Meta-analysis of randomized controlled trials (MRCT)1Randomized controlled trials (RCT)2Meta-analysis of nonrandomized prospective or case-controlled trials (MNRCT)2Nonrandomized controlled trial (NRCT)2Prospective cohort study (PCS)2Retrospective case-control study (RCCS)3Cross-sectional study (CSS)3Surveillance study (registries, surveys, epidemiologic study, retrospective chart review, mathematical modeling of database) (SS)3Consecutive case series (CCS)3Single case reports (SCR)4No evidence (theory, opinion, consensus, review, or preclinical study) (NE)a Adapted from (1): Endocr Pract. 2010;16:270-283.b 1, strong evidence; 2, intermediate evidence; 3, weak evidence; and 4, no evidence. Open table in a new tab Table 22010 American Association of Clinical Endocrinologists protocol for production of Clinical practice guidelines—step ii: Evidence Analysis and subjective Factorsastudy designData analysisinterpretation of resultsPremise correctnessIntent-to-treatGeneralizabilityAllocation concealment (randomization)Appropriate statisticsLogicalSelection biasIncompletenessAppropriate blindingValidityUsing surrogate end points (especially in “first-in-its-class” intervention)Sample size (beta error)Null hypothesis vs. Bayesian statisticsa Reprinted from (1): Endocr Pract. 2010;16:270-283. Open table in a new tab Table 32010 American Association of Clinical Endocrinologists protocol for production of Clinical practice guidelines—step iii: grading of recommendations; how Different Evidence levels can be mapped to the same recommendation gradeaStarting with the left column, best evidence levels (BELs), subjective factors, and consensus map to recommendation grades in the right column. When subjective factors have little or no impact (“none”), then the BEL is directly mapped to recommendation grades. When subjective factors have a strong impact, then recommendation grades may be adjusted up (“positive” impact) or down (“negative” impact). If a two-thirds consensus cannot be reached, then the recommendation grade is D. NA, not applicable (regardless of the presence or absence of strong subjective factors, the absence of a two-thirds consensus mandates a recommendation grade D).,bReprinted from (1): Endocr Pract. 2010;16:270-283.best evidence levelsubjective factor impactTwo-thirds consensusmappingrecommendation grade1NoneYesDirectA2PositiveYesAdjust upA2NoneYesDirectB1NegativeYesAdjust downB3PositiveYesAdjust upB3NoneYesDirectC2NegativeYesAdjust downC4PositiveYesAdjust upC4NoneYesDirectD3NegativeYesAdjust downD1, 2, 3, 4NANoAdjust downDa Starting with the left column, best evidence levels (BELs), subjective factors, and consensus map to recommendation grades in the right column. When subjective factors have little or no impact (“none”), then the BEL is directly mapped to recommendation grades. When subjective factors have a strong impact, then recommendation grades may be adjusted up (“positive” impact) or down (“negative” impact). If a two-thirds consensus cannot be reached, then the recommendation grade is D. NA, not applicable (regardless of the presence or absence of strong subjective factors, the absence of a two-thirds consensus mandates a recommendation grade D).b Reprinted from (1): Endocr Pract. 2010;16:270-283. Open table in a new tab Table 42010 American Association of Clinical Endocrinologists protocol for production of Clinical practice guidelines—step iv: Examples of QualifiersaReprinted from (1): Endocr Pract. 2010;16:270-283.Cost-effectivenessRisk-benefit analysisEvidence gapsAlternative physician preferences (dissenting opinions)Alternative recommendations (“cascades”)Resource availabilityCultural factorsRelevance (patient-oriented evidence that matters)a Reprinted from (1): Endocr Pract. 2010;16:270-283. Open table in a new tab All primary writers are AACE members and credentialed experts in the field of DM care. This CPG has been reviewed and approved by the primary writers, other invited experts, the AACE Publications Committee, and the AACE Board of Directors before submission for peer review by Endocrine Practice. All primary writers made disclosures regarding multiplicities of interests and attested that they are not employed by industry. Reference citations in the text of this document include the reference number, numerical descriptor (e.g., EL 1, 2, 3, or 4), and semantic descriptor (Table 1). Recommendations are based on the quality of supporting evidence (Table 2), all of which have also been rated (Table 3). This CPG is organized into specific and relevant clinical questions labeled “Q.” Recommendations (numerically labeled “R1, R2, etc.”) are based on importance and evidence (Grades A, B, and C) or expert opinion when there is a lack of conclusive clinical evidence (Grade D). The best EL (BEL), which corresponds to the best conclusive evidence found in the Appendix to follow, accompanies the recommendation grade in this Executive Summary; definitions of evidence levels are provided in Figure 1 and Table 1 (2.Mechanick J.I. Camacho P.M. Cobin R.H. et al.American Association of Clinical Endocrinologists Protocol for Standardized Production of Clinical Practice Guidelines--2010 update.Endocr Pract. 2010; 16 ([EL 4; CPG NE; see Fig. 1; Tables 1-4]): 270-283Abstract Full Text Full Text PDF PubMed Scopus (0) Google Scholar [EL 4; CPG NE; see Fig. 1; Table 1, Table 2, Table 3, Table 4]). Comments may be appended to the recommendation grade and BEL regarding any relevant subjective factors that may have influenced the grading process (Table 4). Details regarding each recommendation may be found in the corresponding section of the Appendix. Thus, the process leading to a final recommendation and grade is not rigid; rather, it incorporates a complex expert integration of objective and subjective factors meant to reflect optimal real-life clinical decision-making and enhance patient care. Where appropriate, multiple recommendations are provided so that the reader has management options. This document is only intended to serve as a guideline. Individual patient circumstances and presentations differ, and the ultimate clinical management is based on what is in the best interest of the individual patient, involving patient input and reasonable clinical judgment by the treating clinicians. To guide readers, DM comprehensive management recommendations are organized into the following questions:•Q1. How is diabetes screened and diagnosed?•Q2. How is prediabetes managed?•Q3. What are the glycemic treatment goals of DM?•Q4. How are glycemic targets achieved for type 2 diabetes (T2D)?•Q5. How should glycemia in type 1 diabetes (T1D) be managed?•Q6. How is hypoglycemia managed?•Q7. How is hypertension managed in patients with diabetes?•Q8. How is dyslipidemia managed in patients with diabetes?•Q9. How is nephropathy managed in patients with diabetes?•Q10. How is retinopathy managed in patients with diabetes?•Q11. How is neuropathy diagnosed and managed in patients with diabetes?•Q12. How is CVD managed in patients with diabetes?•Q13. How is obesity managed in patients with diabetes?•Q14. What is the role of sleep medicine in the care of the patient with diabetes?•Q15. How is diabetes managed in the hospital?•Q16. How is a comprehensive diabetes care plan established in children and adolescents?•Q17. How should diabetes in pregnancy be managed?•Q18. When and how should glucose monitoring be used?•Q19. When and how should insulin pump therapy be used?•Q20. What is the imperative for education and team approach in DM management?•Q21. Which vaccinations should be given to patients with diabetes?•Q22. How should depression be managed in the context of diabetes?•Q23. What is the association between diabetes and cancer?•Q24. Which occupations have specific diabetes management requirements? Readers are referred to the Appendix (section 4) for more detail and supporting evidence for each question. •R1. There is a continuum of risk for poor health outcomes in the progression from normal glucose tolerance to overt T2D. Screening should be considered in the presence of risk factors for DM (Table 5) (Grade C; BEl 3). Individuals at risk for DM whose glucose values are in the normal range should be screened every 3 years; clinicians may consider annual screening for patients with 2 or more risk factors (Grade C; BEl 3).Table 5Risk Factors for Prediabetes and T2D: Criteria for Testing for Diabetes in Asymptomatic AdultsAge ≥45 years without other risk factorsCVD or family history of T2DOverweight or obeseaTesting should be considered in all adults who are obese (BMI ≥30 kg/m2), and those who are overweight (BMI 25 to <30 kg/m2) and have additional risk factors. At-risk BMI may be lower in some ethnic groups, in whom parameters such as waist circumference and other factors may be used.Sedentary lifestyleMember of an at-risk racial or ethnic group: Asian, African American, Hispanic, Native American (Alaska Natives and American Indians), or Pacific IslanderHDL-C <35 mg/dL (0.90 mmol/L) and/or a triglyceride level >250 mg/dL (2.82 mmol/L)IGT, IFG, and/or metabolic syndromePCOS, acanthosis nigricans, NAFLDHypertension (BP >140/90 mm Hg or on therapy for hypertension)History of gestational diabetes or delivery of a baby weighing more than 4 kg (9 lb)Antipsychotic therapy for schizophrenia and/or severe bipolar diseaseChronic glucocorticoid exposureSleep disorders in the presence of glucose intolerance (A1C >5.7%, IGT, or IFG on previous testing), including OSA, chronic sleep deprivation, and night-shift occupationAbbreviations: A1C = hemoglobin A1C; BP = blood pressure; CVD = cardiovascular disease; HDL-C = high-density lipoprotein cholesterol; IFG = impaired fasting glucose; IGT = impaired glucose tolerance; NAFLD = nonalcoholic fatty liver disease; OSA = obstructive sleep apnea; PCOS = polycystic ovary syndrome.a Testing should be considered in all adults who are obese (BMI ≥30 kg/m2), and those who are overweight (BMI 25 to <30 kg/m2) and have additional risk factors. At-risk BMI may be lower in some ethnic groups, in whom parameters such as waist circumference and other factors may be used. Open table in a new tab •R2. The following criteria may be used to diagnose DM (Table 6) (Grade B; BEl 3):Table 6Glucose Testing and interpretationNormalHigh risk for DiabetesDiabetesFPG <100 mg/dLIFGFPG ≥100-125 mg/dLFPG ≥126 mg/dL2-h PG <140 mg/dLIGT2-h PG ≥140-199 mg/dL2-h PG ≥200 mg/dL Random PG ≥200 mg/dL + symptomsA1C <5.5%5.5 to 6.4%For screening of prediabetesaA1C should be used only for screening prediabetes. The diagnosis of prediabetes, which may manifest as either IFG or IGT, should be confirmed with glucose testing.≥6.5% SecondarybGlucose criteria are preferred for the diagnosis of DM. In all cases, the diagnosis should be confirmed on a separate day by repeating glucose or A1C testing. When A1C is used for diagnosis, follow-up glucose testing should be done when possible to help manage DM.Abbreviations: A1C = hemoglobin A1C; FPG = fasting plasma glucose; IFG = impaired fasting glucose; IGT = impaired glucose tolerance; PG = plasma glucose.a A1C should be used only for screening prediabetes. The diagnosis of prediabetes, which may manifest as either IFG or IGT, should be confirmed with glucose testing.b Glucose criteria are preferred for the diagnosis of DM. In all cases, the diagnosis should be confirmed on a separate day by repeating glucose or A1C testing. When A1C is used for diagnosis, follow-up glucose testing should be done when possible to help manage DM. Open table in a new tab •FPG concentration (after 8 or more hours of no caloric intake) ≥126 mg/dL, or•Plasma glucose concentration ≥200 mg/dL 2 hours after ingesting a 75-g oral glucose load in the morning after an overnight fast of at least 8 hours, or•Symptoms of hyperglycemia (e.g., polyuria, polydipsia, polyphagia) and a random (casual, nonfasting) plasma glucose concentration ≥200 mg/dL, or•A1C level ≥6.5% Abbreviations: A1C = hemoglobin A1C; BP = blood pressure; CVD = cardiovascular disease; HDL-C = high-density lipoprotein cholesterol; IFG = impaired fasting glucose; IGT = impaired glucose tolerance; NAFLD = nonalcoholic fatty liver disease; OSA = obstructive sleep apnea; PCOS = polycystic ovary syndrome. Abbreviations: A1C = hemoglobin A1C; FPG = fasting plasma glucose; IFG = impaired fasting glucose; IGT = impaired glucose tolerance; PG = plasma glucose. Glucose criteria (i.e., FPG or 2-h glucose after a 75-g oral glucose load) are preferred for the diagnosis of DM. The same test—plasma glucose or A1C measurement—should be repeated on a different day to confirm the diagnosis of DM. However, a glucose level ≥200 mg/dL in the presence of DM symptoms does not need to be confirmed (Grade B; BEl 3).•R3. Prediabetes may be identified by the presence of impaired glucose tolerance (IGT), which is a plasma glucose value of 140 to 199 mg/dL 2 hours after ingesting 75 g of glucose, and/or impaired fasting glucose (IFG), which is a fasting glucose value of 100 to 125 mg/dL (Table 6) (Grade B; BEl 2). A1C values between 5.5 and 6.4% inclusive should be a signal to do more specific glucose testing (Grade D; BEl 4). For prediabetes, A1C testing should be used only as a screening tool; FPG measurement or an oral glucose tolerance test (OGTT) should be used for definitive diagnosis (Grade B; BEl 2). Metabolic syndrome based on National Cholesterol Education Program IV Adult Treatment Panel III criteria should be considered a prediabetes equivalent (Grade C; BEl 3).•R4. Pregnant females with DM risk factors should be screened at the first prenatal visit for undiagnosed T2D using standard criteria (Grade D; BEl 4). At 24 to 28 weeks’ gestation, all pregnant subjects should be screened for gestational DM (GDM) with a 2-hour OGTT using a 75-g glucose load. GDM may be diagnosed using the following plasma glucose criteria: FPG >92 mg/ dL, 1-hour post-glucose challenge value ≥180 mg/dL, or 2-hour value ≥153 mg/dL (Grade C; BEl 3).•R5. DM represents a group of heterogeneous metabolic disorders that develop when insulin secretion is insufficient to maintain normal plasma glucose levels. T2D is the most common form of DM, accounting for more than 90% of cases, and is typically identified in patients who are overweight or obese and/or have a family history of DM, a history of GDM, or meet the criteria for metabolic syndrome. Once DM glucose criteria have been satisfied, T2D should be diagnosed based on patient history, phenotype, and lack of autoantibodies characteristic of T1D (Grade A; BEl 1). Most persons with T2D have evidence of insulin resistance (such as elevated fasting or postprandial plasma insulin and/or elevated C-peptide concentrations), high triglycerides, and/or low high-density lipoprotein cholesterol [HDL-C]).•R6. T1D is usually characterized by absolute insulin deficiency and should be confirmed by the presence of autoantibodies to glutamic acid decarboxylase, pancreatic islet β cells (tyrosine phosphatase IA-2), zinc transporter (ZnT8), and/ or insulin (Grade A; BEl 1). Some forms of T1D have no evidence of autoimmunity and have been termed idiopathic. T1D can also occur in people who are overweight or obese. Therefore, documenting the levels of insulin and C-peptide and the presence or absence of immune markers in addition to the clinical presentation may help establish the correct diagnosis to distinguish between T1D and T2D in children or adults and determine appropriate treatment (Grade B; BEl 2).•R7. Any child or young adult with an atypical presentation, course, or response to therapy may be evaluated for monogenic DM (formerly matu rity-onset diabetes of the young); diagnostic like lihood is strengthened by a family history over 3 generations, suggesting autosomal dominant inheritance (Grade C; BEl 3). •R8. T2D can be prevented or at least delayed by intervening in persons who have prediabetes (see Table 6 for glucose criteria) (Grade A, BEl 1). Frequent measurement of FPG and/or an OGTT may be used to assess the glycemic status of patients with prediabetes (Grade C; BEl 3). The clinician should manage CVD risk factors (especially elevated blood pressure and/or dyslip-idemia) and excessive weight, and monitor these risks at regular intervals (Grade C; BEl 3).•R9. Persons with prediabetes should modify their lifestyle, including initial attempts to lose 5 to 10% of body weight if overweight or obese and participate in moderate physical activity (e.g., walking) at least 150 minutes per week (Grade B; BEl 3). Physicians should recommend patients participate in organized lifestyle change programs with follow-up, where available, because behavioral support will benefit weight-loss efforts (Grade B; BEl 3)•R10. In addition to lifestyle modification, medications including metformin, acarbose, or thiazolidinediones (TZDs) should be considered for patients who are at moderate-to-high risk for developing DM, such as those with a fist-degree relative with DM (Grade A; BEl 1). •R11. Glucose targets should be individualized and take into account life expectancy, disease duration, presence or absence of micro- and macrovascular complications, CVD risk factors, comorbid conditions, and risk for hypoglycemia, as well as the patient’s psychological status (Grade A; BEl 1). In general, the goal of therapy should be an A1C level ≤6.5% for most nonpregnant adults, if it can be achieved safely (Table 7) (Grade D; BEl 4). To achieve this target A1C level, FPG may need to be <110 mg/dL, and the 2-hour PPG may need to be <140 mg/dL (Table 7) (Grade B, BEl 2).Table 7Comprehensive Diabetes Care Treatment GoalsparameterTreatment goalReference (evidence level and study design)GlucoseA1C, %Individualize on the basis of age, comorbidities, duration of disease; in general ≤6.5 for most; closer to normal for healthy; less stringent for “less healthy”(4.Garber A.J. Abrahamson M.J. Barzilay J.I. et al.American association of clinical endocrinologists/ American college of endocrinology’ comprehensive dia- betes management algorithm 2015.Endocr Pract. 2015; 21 ([EL 4; NE]): 438-447Abstract Full Text Full Text PDF PubMed Scopus (0) Google Scholar [EL 4; NE])FPG, mg/dL<1102-h PPG, mg/dL<140Inpatient hyperglycemia: glucose, mg/dL140-180(5.Moghissi E.S. Korytkowski M.T. Dinardo M. et al.American Association of Clinical Endocrinologists and American Diabetes Association consensus statement on inpatient glycemic control.Endocr Pract. 2009; 15 ([EL 4; consensus NE]): 353-369Abstract Full Text Full Text PDF PubMed Scopus (406) Google Scholar [EL 4; consensus NE])Blood pressureIndividualize on the basis of age, comorbidities, and duration of disease, with general target of:(8.James P.A. Oparil S. Carter B.L. et al.2014 evidence-based guideline for the management of high blood pressure in adults: Report from the panel members appointed to the Eighth Joint National Committee (JNC 8).JAMA. 2014; 311 ([EL 4; NE]): 507-520Crossref PubMed Scopus (4835) Google Scholar [EL 4; NE])Systolic, mm Hg~130Diastolic, mm Hg~80LipidsLCL-C, mg/dL<100, moderate risk <70, high risk(4.Garber A.J. Abrahamson M.J. Barzilay J.I. et al.American association of clinical endocrinologists/ American college of endocrinology’ comprehensive dia- betes management algorithm 2015.Endocr Pract. 2015; 21 ([EL 4; NE]): 438-447Abstract Full Text Full Text PDF PubMed Scopus (0) Google Scholar [EL 4; NE])Non-HDL-C, mg/dL<130, moderate risk <100, high riskTriglycerides, mg/dL<150TC/HDL-C ratio<3.5, moderate risk <3.0, high riskApoB, mg/dL<90, moderate risk <80, high riskLDL particles<1,200 moderate risk <1,000 high riskWeightWeight lossReduce weight by at least 5 to 10%; avoid weight gain(4.Garber A.J. Abrahamson M.J. Barzilay J.I. et al.American association of clinical endocrinologists/ American college of endocrinology’ comprehensive dia- betes management algorithm 2015.Endocr Pract. 2015; 21 ([EL 4; NE]): 438-447Abstract Full Text Full Text PDF PubMed Scopus (0) Google Scholar [EL 4; NE])Anticoagu" @default.
• W4240794548 created "2022-05-12" @default.
• W4240794548 creator A5001574834 @default.
• W4240794548 creator A5013463182 @default.
• W4240794548 creator A5019970806 @default.
• W4240794548 creator A5022782687 @default.
• W4240794548 creator A5023212536 @default.
• W4240794548 creator A5024720272 @default.
• W4240794548 creator A5025059888 @default.
• W4240794548 creator A5029280234 @default.
• W4240794548 creator A5033276269 @default.
• W4240794548 creator A5033587716 @default.
• W4240794548 creator A5034509828 @default.
• W4240794548 creator A5036819133 @default.
• W4240794548 creator A5037652425 @default.
• W4240794548 creator A5045462483 @default.
• W4240794548 creator A5047527237 @default.
• W4240794548 creator A5047565815 @default.
• W4240794548 creator A5049161218 @default.
• W4240794548 creator A5050076657 @default.
• W4240794548 creator A5054058644 @default.
• W4240794548 creator A5057131349 @default.
• W4240794548 creator A5061058170 @default.
• W4240794548 creator A5063671433 @default.
• W4240794548 creator A5065672374 @default.
• W4240794548 creator A5065887422 @default.
• W4240794548 creator A5069336249 @default.
• W4240794548 creator A5070276458 @default.
• W4240794548 creator A5070289715 @default.
• W4240794548 creator A5076048620 @default.
• W4240794548 creator A5079713067 @default.
• W4240794548 creator A5081667069 @default.
• W4240794548 creator A5081834796 @default.
• W4240794548 creator A5084440394 @default.
• W4240794548 creator A5084919594 @default.
• W4240794548 creator A5088412188 @default.
• W4240794548 date "2015-04-01" @default.
• W4240794548 modified "2023-10-05" @default.
• W4240794548 title "American Association Of Clinical Endocrinologists And American College Of Endocrinology -Clinical Practice Guidelines For Developing A Diabetes Mellitus Comprehensive Care Plan – 2015" @default.
• W4240794548 cites W112354868 @default.
• W4240794548 cites W12423254 @default.
• W4240794548 cites W1427631803 @default.
• W4240794548 cites W1492825867 @default.
• W4240794548 cites W1497829453 @default.
• W4240794548 cites W1502524639 @default.
• W4240794548 cites W1504268385 @default.
• W4240794548 cites W1511593276 @default.
• W4240794548 cites W1513833217 @default.
• W4240794548 cites W1519335354 @default.
• W4240794548 cites W1526927233 @default.
• W4240794548 cites W1538332611 @default.
• W4240794548 cites W1538553036 @default.
• W4240794548 cites W1543166702 @default.
• W4240794548 cites W1553414890 @default.
• W4240794548 cites W1553483712 @default.
• W4240794548 cites W1554005703 @default.
• W4240794548 cites W1592674309 @default.
• W4240794548 cites W1604542334 @default.
• W4240794548 cites W1656841135 @default.
• W4240794548 cites W172609984 @default.
• W4240794548 cites W1752045965 @default.
• W4240794548 cites W1819182952 @default.
• W4240794548 cites W1836189764 @default.
• W4240794548 cites W1892385952 @default.
• W4240794548 cites W1936024680 @default.
• W4240794548 cites W1957007052 @default.
• W4240794548 cites W1963522116 @default.
• W4240794548 cites W1963557257 @default.
• W4240794548 cites W1964413807 @default.
• W4240794548 cites W1965139875 @default.
• W4240794548 cites W1965620761 @default.
• W4240794548 cites W1965722550 @default.
• W4240794548 cites W1965913104 @default.
• W4240794548 cites W1967917591 @default.
• W4240794548 cites W1970564380 @default.
• W4240794548 cites W1970638723 @default.
• W4240794548 cites W1970945844 @default.
• W4240794548 cites W1972204120 @default.
• W4240794548 cites W1972352298 @default.
• W4240794548 cites W1973361408 @default.
• W4240794548 cites W1974413439 @default.
• W4240794548 cites W1974667696 @default.
• W4240794548 cites W1974792145 @default.
• W4240794548 cites W1975018096 @default.
• W4240794548 cites W1975372714 @default.
• W4240794548 cites W1975663485 @default.
• W4240794548 cites W1975777549 @default.
• W4240794548 cites W1975801154 @default.
• W4240794548 cites W1975897418 @default.
• W4240794548 cites W1976894939 @default.
• W4240794548 cites W1976928728 @default.
• W4240794548 cites W1977102586 @default.
• W4240794548 cites W1977910216 @default.
• W4240794548 cites W1978547975 @default.
• W4240794548 cites W1978822680 @default.
• W4240794548 cites W1979110512 @default.
• W4240794548 cites W1979789349 @default.
• W4240794548 cites W1980024665 @default.

• next