Pub Date : 2021-11-09DOI: 10.33590/emjdiabet/21-00138
Pablo Millares Martin, Rosa Bobet Reyes
Background: Heart failure (HF) is underdiagnosed among patients with diabetes. Awareness is required to improve its management and to reduce its impact. Objectives: To suggest a risk assessment tool that could facilitate the early diagnosis of HF and even reduce its incidence by facilitating individualised management plans. Methods: Assess current medical literature, searching for parameters that indicate a higher risk of HF among the diabetic population. Results: Twenty-four parameters were found that could be the potential basis for a risk stratification tool. Conclusion: The concept of a risk stratification tool is presented. Work on validating will be required. It has the potential to affect the future management of patients with diabetes and to reduce the incidence and prevalence of HF in this population.
{"title":"Screening for Heart Failure in Diabetes: A Way to Reduce Its Prevalence? A Proof of Concept of a Risk Assessment Tool","authors":"Pablo Millares Martin, Rosa Bobet Reyes","doi":"10.33590/emjdiabet/21-00138","DOIUrl":"https://doi.org/10.33590/emjdiabet/21-00138","url":null,"abstract":"Background: Heart failure (HF) is underdiagnosed among patients with diabetes. Awareness is required to improve its management and to reduce its impact.\u0000\u0000Objectives: To suggest a risk assessment tool that could facilitate the early diagnosis of HF and even reduce its incidence by facilitating individualised management plans.\u0000\u0000Methods: Assess current medical literature, searching for parameters that indicate a higher risk of HF among the diabetic population.\u0000\u0000Results: Twenty-four parameters were found that could be the potential basis for a risk stratification tool.\u0000\u0000Conclusion: The concept of a risk stratification tool is presented. Work on validating will be required. It has the potential to affect the future management of patients with diabetes and to reduce the incidence and prevalence of HF in this population.","PeriodicalId":418035,"journal":{"name":"EMJ Diabetes","volume":"24 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114373375","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-11-09DOI: 10.33590/emjdiabet/21-00191
C. Stehouwer
A 62-year-old female was referred to her primary care physician for newly diagnosed Type 2 diabetes mellitus (T2DM). She was overweight (BMI: 29.1 kg/m2) and had well-controlled hypertension and dyslipidaemia. She stopped smoking 5 months previously, after she had suffered a myocardial infarction. Her history was otherwise unremarkable. Glycated haemoglobin was 8.4% (68 mmol/mol); her estimated glomerular filtration rate was normal and there was no albuminuria. She was moderately physically active and tried to adhere to a healthy diet. She was not motivated to enter a weight-loss programme at this point. Her physician considered pharmacological treatment of her diabetes, especially as intensification of lifestyle changes in this patient would be difficult. How should this patient be advised?
{"title":"Metformin: Arguments for Maintaining its Position as First-Line Pharmacological Treatment in Type 2 Diabetes Mellitus","authors":"C. Stehouwer","doi":"10.33590/emjdiabet/21-00191","DOIUrl":"https://doi.org/10.33590/emjdiabet/21-00191","url":null,"abstract":"A 62-year-old female was referred to her primary care physician for newly diagnosed Type 2 diabetes mellitus (T2DM). She was overweight (BMI: 29.1 kg/m2) and had well-controlled hypertension and dyslipidaemia. She stopped smoking 5 months previously, after she had suffered a myocardial infarction. Her history was otherwise unremarkable. Glycated haemoglobin was 8.4% (68 mmol/mol); her estimated glomerular filtration rate was normal and there was no albuminuria. She was moderately physically active and tried to adhere to a healthy diet. She was not motivated to enter a weight-loss programme at this point. Her physician considered pharmacological treatment of her diabetes, especially as intensification of lifestyle changes in this patient would be difficult. How should this patient be advised?","PeriodicalId":418035,"journal":{"name":"EMJ Diabetes","volume":"85 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133873554","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-11-09DOI: 10.33590/emjdiabet/21-00194
Adrian Li, M. Whyte
Disparities in the distribution of diabetes health have been reported by social class, age, gender, and ethnicity and may arise from an interplay of biological, clinical, and non-clinical factors. As well as being morally wrong, these differences in outcome will have a significant adverse effect on a nation’s health. As a result, there have been international efforts to reduce inequalities, from the strategic organisation of healthcare to providers and patients themselves, with mixed effects. This article outlines the disparities in diabetes care and outcomes in different patient groups, and how the approach of integration of health and social care may help to overcome some of the adverse aspects of societal organisation that underpins disparities.
{"title":"Disparities in Diabetes Care","authors":"Adrian Li, M. Whyte","doi":"10.33590/emjdiabet/21-00194","DOIUrl":"https://doi.org/10.33590/emjdiabet/21-00194","url":null,"abstract":"Disparities in the distribution of diabetes health have been reported by social class, age, gender, and ethnicity and may arise from an interplay of biological, clinical, and non-clinical factors. As well as being morally wrong, these differences in outcome will have a significant adverse effect on a nation’s health. As a result, there have been international efforts to reduce inequalities, from the strategic organisation of healthcare to providers and patients themselves, with mixed effects. This article outlines the disparities in diabetes care and outcomes in different patient groups, and how the approach of integration of health and social care may help to overcome some of the adverse aspects of societal organisation that underpins disparities.","PeriodicalId":418035,"journal":{"name":"EMJ Diabetes","volume":"20 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114466778","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-05-17DOI: 10.33590/EMJDIABET/20-00254
Yigit Akduman, W. Anderson, S. Saxena
COVID-19 is caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) and has been shown to affect a multitude of organ systems. It is often associated with vasculitis or thromboembolic disease with resultant tissue hypoxia. This report presents a case of fast progression diabetic retinopathy in the case of a SARS-CoV-2 infection. The findings conclude that patients with diabetes should be more frequently monitored for emergence or progression of diabetic retinopathy if they present with COVID-19.
{"title":"Fast Progression of Diabetic Retinopathy with SARS-CoV-2 Infection","authors":"Yigit Akduman, W. Anderson, S. Saxena","doi":"10.33590/EMJDIABET/20-00254","DOIUrl":"https://doi.org/10.33590/EMJDIABET/20-00254","url":null,"abstract":"COVID-19 is caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) and has been shown to affect a multitude of organ systems. It is often associated with vasculitis or thromboembolic disease with resultant tissue hypoxia. This report presents a case of fast progression diabetic retinopathy in the case of a SARS-CoV-2 infection. The findings conclude that patients with diabetes should be more frequently monitored for emergence or progression of diabetic retinopathy if they present with COVID-19.","PeriodicalId":418035,"journal":{"name":"EMJ Diabetes","volume":"16 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123649833","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-11-10DOI: 10.33590/emjdiabet/20-00171
S. Ray, Subhodip Pramanik
Deterioration in reproductive functions is one of the most serious complications of Type 2 diabetes mellitus (T2DM). Neuropathy, angiopathy, oxidative stress, and psychological deviation are the important causative factors in developing reproductive dysfunctions in diabetes. In males, the principal complications are erectile dysfunction (ED), ejaculatory disorders, and functional hypogonadism. Low serum testosterone is frequently observed in males with T2DM but the neuroendocrine pathophysiology is yet to be defined; this reduction in testosterone levels decreases libido. Evaluation of testosterone levels of male diabetic patients with hypogonadism symptoms is recommended. Hypogonadal males with diabetes might benefit from testosterone replacement therapy. However, there is a need for adequately powered long-term studies in this context. Impairment in sexual function is a common complication in males with diabetes. The pathophysiology of sexual dysfunction in diabetes is multifactorial. Males with diabetes have a >3-fold increase in the risk of ED compared to their nondiabetic counterparts. Phosphodiesterase type 5 inhibitors should be considered as first-line therapy in males with T2DM and ED. Nearly 50% of male diabetic patients presented some degree of subfertility or infertility. Alterations in sperm parameters and hormone levels can contribute to diabetes-related male infertility. Endocrinologists, diabetologists, and physicians should address sexual complaints of their patients since these problems can significantly impair their quality of life.
{"title":"Reproductive Dysfunctions in Males with Type 2 Diabetes Mellitus: An Updated Review","authors":"S. Ray, Subhodip Pramanik","doi":"10.33590/emjdiabet/20-00171","DOIUrl":"https://doi.org/10.33590/emjdiabet/20-00171","url":null,"abstract":"Deterioration in reproductive functions is one of the most serious complications of Type 2 diabetes mellitus (T2DM). Neuropathy, angiopathy, oxidative stress, and psychological deviation are the important causative factors in developing reproductive dysfunctions in diabetes. In males, the principal complications are erectile dysfunction (ED), ejaculatory disorders, and functional hypogonadism. Low serum testosterone is frequently observed in males with T2DM but the neuroendocrine pathophysiology is yet to be defined; this reduction in testosterone levels decreases libido. Evaluation of testosterone levels of male diabetic patients with hypogonadism symptoms is recommended. Hypogonadal males with diabetes might benefit from testosterone replacement therapy. However, there is a need for adequately powered long-term studies in this context. Impairment in sexual function is a common complication in males with diabetes. The pathophysiology of sexual dysfunction in diabetes is multifactorial. Males with diabetes have a >3-fold increase in the risk of ED compared to their nondiabetic counterparts. Phosphodiesterase type 5 inhibitors should be considered as first-line therapy in males with T2DM and ED. Nearly 50% of male diabetic patients presented some degree of subfertility or infertility. Alterations in sperm parameters and hormone levels can contribute to diabetes-related male infertility. Endocrinologists, diabetologists, and physicians should address sexual complaints of their patients since these problems can significantly impair their quality of life.","PeriodicalId":418035,"journal":{"name":"EMJ Diabetes","volume":"PP 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-11-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126528476","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-11-10DOI: 10.33590/emjdiabet/19-00177
G. Derosa, R. Rivera, A. D'Angelo, P. Maffioli
Type 2 diabetes mellitus is currently the main cause of chronic kidney disease, leading to end-stage renal disease in most countries around the world. Metformin is the most commonly prescribed oral antihyperglycaemic in the world and after approval by the U.S. Food and Drug Administration (FDA) in 1994, it is currently recommended as the first-line pharmacological agent for newly diagnosed Type 2 diabetes mellitus by many professional diabetes associations. In this review, the authors analysed efficacy and safety of metformin in patients with chronic kidney disease.
{"title":"Metformin: From Immediate Release to Extended Release Formula, Effectiveness, And Safety in Patients With Chronic Kidney Disease","authors":"G. Derosa, R. Rivera, A. D'Angelo, P. Maffioli","doi":"10.33590/emjdiabet/19-00177","DOIUrl":"https://doi.org/10.33590/emjdiabet/19-00177","url":null,"abstract":"Type 2 diabetes mellitus is currently the main cause of chronic kidney disease, leading to end-stage renal disease in most countries around the world. Metformin is the most commonly prescribed oral antihyperglycaemic in the world and after approval by the U.S. Food and Drug Administration (FDA) in 1994, it is currently recommended as the first-line pharmacological agent for newly diagnosed Type 2 diabetes mellitus by many professional diabetes associations. In this review, the authors analysed efficacy and safety of metformin in patients with chronic kidney disease.","PeriodicalId":418035,"journal":{"name":"EMJ Diabetes","volume":"40 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-11-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127100118","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-11-10DOI: 10.33590/emjdiabet/20-00119
C. Chukwunyere, D. Awonuga, O. Adesina, I. Udenze
Objective: Gestational diabetes is glucose intolerance of varying severity with onset in the index pregnancy. This study aimed to compare fasting plasma glucose (FPG) with random plasma glucose (RPG) among pregnant females as methods of screening for gestational diabetes. Methods: A cross-sectional study of 100 pregnant females selected to have screening for gestational diabetes between gestational ages of 24 and 28 weeks using RPG and FPG. All the subjects had 75 g oral glucose tolerance test as the gold standard. Venous plasma glucose assay was performed using glucose oxidase method. Results: The prevalence of gestational diabetes was 29% using FPG cut-off ≥5.1 mmol/L and 6% using RPG cut-off ≥7.8 mmol/L. The RPG cut-off ≥11.1 mmol/L gave the lowest prevalence rate of 2%, while 75 g oral glucose tolerance test (gold standard test) gave the highest prevalence rate of 30%. RPG cut-off ≥7.8 mmol/L revealed a positive-predictive value of 66.7%, negative-predictive value of 72.3%, and area under the curve of 0.845 compared with FPG level at threshold of 5.1 mmol/L, which gave positive-predictive value of 93.1%, negative-predictive value of 95.8%, and area under the curve 0.920. Conclusion: This study revealed that FPG threshold of 5.1 mmol/L alone performed excellently as a screening test.
{"title":"Gestational Diabetes: Comparison of Random and Fasting Plasma Glucose as Modalities of Screening","authors":"C. Chukwunyere, D. Awonuga, O. Adesina, I. Udenze","doi":"10.33590/emjdiabet/20-00119","DOIUrl":"https://doi.org/10.33590/emjdiabet/20-00119","url":null,"abstract":"Objective: Gestational diabetes is glucose intolerance of varying severity with onset in the index pregnancy. This study aimed to compare fasting plasma glucose (FPG) with random plasma glucose (RPG) among pregnant females as methods of screening for gestational diabetes.\u0000\u0000Methods: A cross-sectional study of 100 pregnant females selected to have screening for gestational diabetes between gestational ages of 24 and 28 weeks using RPG and FPG. All the subjects had 75 g oral glucose tolerance test as the gold standard. Venous plasma glucose assay was performed using glucose oxidase method.\u0000\u0000Results: The prevalence of gestational diabetes was 29% using FPG cut-off ≥5.1 mmol/L and 6% using RPG cut-off ≥7.8 mmol/L. The RPG cut-off ≥11.1 mmol/L gave the lowest prevalence rate of 2%, while 75 g oral glucose tolerance test (gold standard test) gave the highest prevalence rate of 30%. RPG cut-off ≥7.8 mmol/L revealed a positive-predictive value of 66.7%, negative-predictive value of 72.3%, and area under the curve of 0.845 compared with FPG level at threshold of 5.1 mmol/L, which gave positive-predictive value of 93.1%, negative-predictive value of 95.8%, and area under the curve 0.920.\u0000\u0000Conclusion: This study revealed that FPG threshold of 5.1 mmol/L alone performed excellently as a screening test.","PeriodicalId":418035,"journal":{"name":"EMJ Diabetes","volume":"41 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-11-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121500583","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-11-10DOI: 10.33590/emjdiabet/20-00174
N. A. Bhat, K. Muliyala, S. Chaturvedi
Diabetes is fundamentally a chronic metabolic disorder, yet it has established psychological connections and consequences. The present article offers an overview of some of the established findings with respect to the psychological aspects of diabetes among adults and adolescents. This narrative review describes the psychological impact of diabetes and the manner in which psychological functioning of the individual affects the development, management, and outcome of diabetes. Diabetes can lead to a great deal of distress, common mental health problems such as anxiety, depression, and sleep disorders, and can increase the risk of suicide. It also affects cognitive functioning across multiple domains such as attention, concentration, memory, executive function, and information processing speed. Diabetes is a burdensome life condition that significantly reduces quality of life. Personality characteristics can have both positive and negative impacts on self-management of diabetes, and some personality profiles, especially the distressed/Type D personality, are indicative of poor prognosis and greater chances of developing medical complications. Psychological interventions such as cognitive behaviour therapy, acceptance and commitment therapy, behavioural activation, and counselling strategies such as educational programmes, problem solving training, and motivational interviewing have proven very effective in coping with diabetes distress, managing comorbid mental health problems, and increasing adherence to self-care and antidiabetic behaviours. Additionally, yogic practices have also shown promising results for self-management of diabetes. Paediatric diabetes especially presents unique psychosocial challenges to patient management and affects academic performance of children and career choices of affected individuals.
{"title":"Psychological Aspects of Diabetes","authors":"N. A. Bhat, K. Muliyala, S. Chaturvedi","doi":"10.33590/emjdiabet/20-00174","DOIUrl":"https://doi.org/10.33590/emjdiabet/20-00174","url":null,"abstract":"Diabetes is fundamentally a chronic metabolic disorder, yet it has established psychological connections and consequences. The present article offers an overview of some of the established findings with respect to the psychological aspects of diabetes among adults and adolescents. This narrative review describes the psychological impact of diabetes and the manner in which psychological functioning of the individual affects the development, management, and outcome of diabetes. Diabetes can lead to a great deal of distress, common mental health problems such as anxiety, depression, and sleep disorders, and can increase the risk of suicide. It also affects cognitive functioning across multiple domains such as attention, concentration, memory, executive function, and information processing speed. Diabetes is a burdensome life condition that significantly reduces quality of life. Personality characteristics can have both positive and negative impacts on self-management of diabetes, and some personality profiles, especially the distressed/Type D personality, are indicative of poor prognosis and greater chances of developing medical complications. Psychological interventions such as cognitive behaviour therapy, acceptance and commitment therapy, behavioural activation, and counselling strategies such as educational programmes, problem solving training, and motivational interviewing have proven very effective in coping with diabetes distress, managing comorbid mental health problems, and increasing adherence to self-care and antidiabetic behaviours. Additionally, yogic practices have also shown promising results for self-management of diabetes. Paediatric diabetes especially presents unique psychosocial challenges to patient management and affects academic performance of children and career choices of affected individuals.","PeriodicalId":418035,"journal":{"name":"EMJ Diabetes","volume":"87 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-11-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126376084","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-10-14DOI: 10.33590/emjdiabet/201014
P. Rossing, Tami Sadusky
Prof de Boer opened this virtual seminar on the new Kidney Disease: Improving Global Outcomes (KDIGO) clinical practice guideline on diabetes management in chronic kidney disease (CKD), which is the first set of KDIGO guidance on this topic. Prof de Boer emphasised that the aim of the guideline was to generate a useful resource for clinicians and patients, to address relevant questions with actionable recommendations supplemented by practice points, to take on controversial topics when sufficient evidence was available, and to communicate findings clearly and concisely. The scope of the new guideline includes patients with Type 1 diabetes mellitus, Type 2 diabetes mellitus, and all severities of CKD, including patients treated with dialysis or kidney transplantation. The new guideline also includes recommendations related to lifestyle, pharmacotherapy, and the organisation of healthcare systems, addressed using systematically identified data from randomised controlled trials. Topics such as blood pressure control and lipid management and prevention of and screening for diabetes are not covered by the new KDIGO guideline and have been addressed either in prior KDIGO publications or in other international guidelines. After his introduction, Prof de Boer handed over to Prof Rossing, who offered a detailed overview of the new guidelines, and Ms Sadusky, who highlighted the contribution of patients in the development of the guidelines. Prof Rossing and Ms Sadusky concluded the seminar by emphasising the importance of shared decision-making, where the patient is involved in defining individualised treatment goals, and the critical need for a team-based approach in the care of patients with diabetes and CKD.
de Boer教授为新的肾脏疾病:改善慢性肾脏疾病(CKD)糖尿病管理临床实践指南(KDIGO)的虚拟研讨会揭幕，这是KDIGO关于该主题的第一套指南。de Boer教授强调，该指南的目的是为临床医生和患者提供有用的资源，以可操作的建议补充实践点来解决相关问题，在有足够证据的情况下处理有争议的话题，并清晰简洁地传达研究结果。新指南的范围包括1型糖尿病、2型糖尿病和所有严重CKD患者，包括接受透析或肾移植治疗的患者。新指南还包括与生活方式、药物治疗和卫生保健系统组织有关的建议，这些建议使用随机对照试验系统识别的数据来解决。诸如血压控制和血脂管理以及糖尿病的预防和筛查等主题不包括在新的KDIGO指南中，这些主题已经在以前的KDIGO出版物或其他国际指南中得到了解决。在他的介绍之后，de Boer教授将讲台交给Rossing教授，Rossing教授详细概述了新指南，Sadusky女士则强调了患者在指南制定过程中的贡献。Rossing教授和Sadusky女士在总结研讨会时强调了共同决策的重要性，即患者参与确定个性化治疗目标，以及在糖尿病和慢性肾病患者的护理中迫切需要以团队为基础的方法。
{"title":"Kidney Disease: Improving Global Outcomes (KDIGO) New Guideline for Diabetes Management in Chronic Kidney Disease: A Meet-the-Expert Session","authors":"P. Rossing, Tami Sadusky","doi":"10.33590/emjdiabet/201014","DOIUrl":"https://doi.org/10.33590/emjdiabet/201014","url":null,"abstract":"Prof de Boer opened this virtual seminar on the new Kidney Disease: Improving Global Outcomes (KDIGO) clinical practice guideline on diabetes management in chronic kidney disease (CKD), which is the first set of KDIGO guidance on this topic. Prof de Boer emphasised that the aim of the guideline was to generate a useful resource for clinicians and patients, to address relevant questions with actionable recommendations supplemented by practice points, to take on controversial topics when sufficient evidence was available, and to communicate findings clearly and concisely. The scope of the new guideline includes patients with Type 1 diabetes mellitus, Type 2 diabetes mellitus, and all severities of CKD, including patients treated with dialysis or kidney transplantation. The new guideline also includes recommendations related to lifestyle, pharmacotherapy, and the organisation of healthcare systems, addressed using systematically identified data from randomised controlled trials. Topics such as blood pressure control and lipid management and prevention of and screening for diabetes are not covered by the new KDIGO guideline and have been addressed either in prior KDIGO publications or in other international guidelines.\u0000\u0000After his introduction, Prof de Boer handed over to Prof Rossing, who offered a detailed overview of the new guidelines, and Ms Sadusky, who highlighted the contribution of patients in the development of the guidelines. Prof Rossing and Ms Sadusky concluded the seminar by emphasising the importance of shared decision-making, where the patient is involved in defining individualised treatment goals, and the critical need for a team-based approach in the care of patients with diabetes and CKD.","PeriodicalId":418035,"journal":{"name":"EMJ Diabetes","volume":"103 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133074607","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-06-08DOI: 10.33590/emjdiabet/200608
M. Balasubramanyam
As the COVID-19 outbreak continues to endanger global health and hamper the world economy, there are concerns and reconsiderations for medication taken by patients with cardiometabolic disorders as they are more vulnerable to COVID-19. While several articles and perspectives have dealt with the concern and safe continuation of antihypertensive drugs, there is paucity of information on calcium channel blockers (CCB). Despite the biology of calcium channel involvement in virus entry and replication, the beneficial effect of CCB is somewhat speculative and only preclinically evident. This commentary focusses on the clinical research on CCB in the context of COVID-19.
{"title":"COVID-19: Is it time to revisit the research on calcium channel drug targets?","authors":"M. Balasubramanyam","doi":"10.33590/emjdiabet/200608","DOIUrl":"https://doi.org/10.33590/emjdiabet/200608","url":null,"abstract":"As the COVID-19 outbreak continues to endanger global health and hamper the world economy, there are concerns and reconsiderations for medication taken by patients with cardiometabolic disorders as they are more vulnerable to COVID-19. While several articles and perspectives have dealt with the concern and safe continuation of antihypertensive drugs, there is paucity of information on calcium channel blockers (CCB). Despite the biology of calcium channel involvement in virus entry and replication, the beneficial effect of CCB is somewhat speculative and only preclinically evident. This commentary focusses on the clinical research on CCB in the context of COVID-19.","PeriodicalId":418035,"journal":{"name":"EMJ Diabetes","volume":"8 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129556859","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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