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Insights into the Feasibility and Acceptability of a Mobile Insulin Titration Application in Clinical Practice and Its Effects on Diabetes Outcomes. 洞察移动胰岛素滴定应用程序在临床实践中的可行性和可接受性及其对糖尿病结果的影响。
Pub Date : 2024-04-01 Epub Date: 2024-02-29 DOI: 10.17925/EE.2024.20.1.10
Jodi S Krall, Jason M Ng, Neha Mehrotra, Kristine Ruppert, Linda M Siminerio

Introduction: Insulin therapy is most effective if patients learn how to properly adjust insulin to achieve glycaemic targets. There is a need for methods and tools that can assist these processes in clinical practice. The purpose of this feasibility study was to evaluate an approach to support insulin dose adjustment in individual patients using a mobile titration application (app). Methods: A cohort of adults (N=36) with type 2 diabetes with suboptimal glycaemia who were starting basal insulin self-titration were trained by a diabetes care and education specialist to use a mobile titration app to guide adjusting insulin doses. Glycaemia, diabetes distress and patient and provider satisfaction were assessed during the first 3 months after initiating basal insulin titration using the mobile app. Results: Mean haemoglobin type A1c (HbA1c) was significantly reduced by an average of 2.1 ± 2.2% from baseline to 3 months (p<0.001). Diabetes distress significantly decreased from baseline to follow-up with scores going down (or improving) across all scales. Both patients and providers reported high levels of satisfaction and positive experiences. Conclusion: The model offers a promising solution to streamline insulin dosage adjustments to achieve specific clinical and self-management goals with high expectations for long-term benefits and warrants further investigation.

简介:如果患者学会如何正确调整胰岛素以达到血糖目标,胰岛素治疗就能发挥最大功效。在临床实践中,需要能辅助这些过程的方法和工具。本可行性研究旨在评估一种使用移动滴定应用程序(App)支持个体患者调整胰岛素剂量的方法。研究方法由糖尿病护理和教育专家对开始自行滴注基础胰岛素的 2 型糖尿病成人患者(36 人)进行培训,让他们使用手机滴注应用程序指导调整胰岛素剂量。在开始使用手机应用滴定基础胰岛素后的头 3 个月,对血糖、糖尿病困扰以及患者和医疗服务提供者的满意度进行了评估。结果显示从基线到 3 个月期间,平均血红蛋白 A1c(HbA1c)平均显著降低了 2.1 ± 2.2%(p 结论:该模型为简化胰岛素剂量管理提供了一种有前途的解决方案:该模型为简化胰岛素剂量调整以实现特定的临床和自我管理目标提供了一种很有前景的解决方案,具有很高的长期效益预期,值得进一步研究。
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引用次数: 0
Metabolic Dysfunction-associated Fatty Liver Disease: An Urgent Call for Global Action. 代谢功能障碍相关性脂肪肝:全球行动的紧急呼吁》。
Pub Date : 2024-04-01 Epub Date: 2023-11-08 DOI: 10.17925/EE.2023.20.1.1
Cornelius J Fernandez, Lakshmi Nagendra, Joseph M Pappachan

There has been an exponential increase in the global prevalence of fatty liver disease in recent years in association with the obesity pandemic worldwide. 'Metabolic dysfunction-associated fatty liver disease', the new terminology adopted by an international panel of experts in 2020 to largely replace the old term 'non-alcoholic fatty liver disease', has now been accepted by most hepatologists and diabetologists across the globe. The term metabolic dysfunction-associated fatty liver disease was created to better reflect the metabolicand liver-specific manifestations and complications of fatty liver disease. It is important to disseminate our current understanding of this enigmatic disease among the global scientific fraternity. Recent publications, including articles from the latest issue of Endocrinology & Metabolism Clinics of North America, are attempting to fill this knowledge gap.

近年来,随着肥胖症在全球的流行,全球脂肪肝发病率呈指数级增长。代谢功能障碍相关性脂肪肝 "是一个国际专家小组于 2020 年采用的新术语,在很大程度上取代了旧术语 "非酒精性脂肪肝",现已被全球大多数肝病学家和糖尿病学家所接受。代谢功能障碍相关性脂肪肝这一术语的出现,更好地反映了脂肪肝的代谢和肝脏特异性表现及并发症。向全球科学界传播我们目前对这一神秘疾病的理解非常重要。最近的出版物,包括最新一期《北美内分泌与代谢临床》(Endocrinology & Metabolism Clinics of North America)上的文章,都在试图填补这一知识空白。
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引用次数: 0
Fezolinetant: A Potential Treatment for Moderate to Severe Vasomotor Symptoms of Menopause. 非索内酯:治疗中度至重度更年期血管运动症状的潜在疗法。
Pub Date : 2023-11-01 Epub Date: 2023-06-15 DOI: 10.17925/EE.2023.19.2.13
Barbara DePree

The most common symptom of menopause is vasomotor symptoms (VMS), which occur in more than 80% of postmenopausal women. Furthermore, VMS are the manifestation of menopause for which women most commonly seek treatment, namely, to address their impacted quality of life, including sleep, and work-and non-work-related productivity. VMS vary in frequency, intensity and duration. Hormone therapy (HT) has been our most effective treatment for VMS and has been approved for this indication by the United States Food and Drug Administration (FDA). Despite being a safe and effective treatment option, many patients and providers are hesitant to consider HT. Moreover, HT is contraindicated for some women. While many over-the-counter and non-HT options are available, we lack data on the efficacy and safety of most of these. This has left a void for women. Fezolinetant was recently approved by the FDA for the treatment of moderate-to-severe VMS. So far, clinical trials have shown positive results in terms of safety and efficacy. Fezolinetant is a non-hormonal, neurokinin 3 receptor antagonist that works in the hypothalamus at the thermoregulatory centre. Blocking the non-hormonal neurokinin 3 receptor antagonist modulates hot flashes and night sweats. As early as 4 weeks from initiating fezolinetant, women experienced a statistically significant reduction of both severity and frequency of VMS per day, resulting in an improved quality of life.

更年期最常见的症状是血管运动症状(VMS),80% 以上的绝经后妇女都会出现这种症状。此外,更年期血管运动症状也是妇女最常寻求治疗的更年期表现,即解决她们受到影响的生活质量,包括睡眠、工作和非工作相关的工作效率。更年期综合症的频率、强度和持续时间各不相同。激素疗法(HT)一直是我们治疗VMS最有效的方法,并已被美国食品药品管理局(FDA)批准用于这一适应症。尽管激素治疗是一种安全有效的治疗方法,但许多患者和医疗服务提供者对激素治疗犹豫不决。此外,高催乳素对某些女性来说是禁忌症。虽然有许多非处方和非 HT 方案,但我们缺乏大多数方案的有效性和安全性数据。这给女性留下了空白。美国食品及药物管理局(FDA)最近批准了用于治疗中度至重度 VMS 的非索内酯(Fezolinetant)。到目前为止,临床试验在安全性和有效性方面都取得了积极的成果。Fezolinetant 是一种非激素类神经激肽 3 受体拮抗剂,作用于下丘脑的体温调节中枢。阻断非激素类神经激肽 3 受体拮抗剂可调节潮热和盗汗。在开始服用非佐林内酯 4 周后,妇女每天出现的 VMS 的严重程度和频率都有了统计学意义上的显著降低,从而提高了生活质量。
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引用次数: 0
Endocrine Hypertension: The Urgent Need for Greater Global Awareness. 内分泌高血压:提高全球认识的迫切需要。
Pub Date : 2023-11-01 Epub Date: 2023-10-20 DOI: 10.17925/EE.2023.19.2.11
Cornelius J Fernandez, Lakshmi Nagendra, Mohammed Alkhalifah, Joseph M Pappachan

Hypertension affects about 1.28 billion adults globally, and significantly increases the risk of chronic morbidity and mortality among sufferers. About 15% of these individuals have secondary hypertension, the majority of whom have dysfunction of one or more endocrine systems as the cause of hypertension. Although adrenal disorders are often identified as the cause of endocrine hypertension, extra-adrenal disease and pituitary disorders also can cause the disease. Timely diagnosis is of paramount importance, because of the potential for a surgical cure or optimal disease control with pharmacotherapy to prevent hypertensive complications. Even with its relatively high prevalence compared with many other chronic illnesses, the diagnosis of endocrine hypertension is often delayed or never made because of poor awareness about the disease among physicians. This review attempts to provide an overview of the disease, with some practical aspects of diagnosis and management of a few of the important disorders causing endocrine hypertension.

高血压影响着全球约 12.8 亿成年人,大大增加了患者的慢性发病率和死亡率。这些人中约有 15%患有继发性高血压,其中大多数人的高血压是由一种或多种内分泌系统功能失调引起的。虽然肾上腺疾病通常被认为是内分泌性高血压的病因,但肾上腺外疾病和垂体疾病也可导致该病。及时诊断至关重要,因为有可能通过手术治愈或通过药物治疗达到最佳的疾病控制效果,从而预防高血压并发症。尽管内分泌性高血压的发病率比许多其他慢性疾病都要高,但由于医生对该病的认识不足,内分泌性高血压的诊断往往被延误或从未确诊。本综述试图对该疾病进行概述,并对引起内分泌性高血压的几种重要疾病的诊断和管理提供一些实用的方法。
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引用次数: 0
Prognostic Biomarkers in Pituitary Tumours: A Systematic Review. 垂体瘤的预后生物标志物:系统综述。
Pub Date : 2023-11-01 Epub Date: 2023-08-09 DOI: 10.17925/EE.2023.19.2.12
Eirini Papadimitriou, Eleftherios Chatzellis, Anastasia Dimitriadi, Gregory A Kaltsas, Stamatios Theocharis, Krystallenia I Alexandraki

Pituitary tumours (PTs) are the second most common intracranial tumour. Although the majority show benign behaviour, they may exert aggressive behaviour and can be resistant to treatment. The aim of this review is to report the recently identified biomarkers that might have possible prognostic value. Studies evaluating potentially prognostic biomarkers or a therapeutic target in invasive/recurrent PTs compared with either non-invasive or non-recurrent PTs or normal pituitaries are included in this review. In the 28 included studies, more than 911 PTs were evaluated. A systematic search identified the expression of a number of biomarkers that may be positively correlated with disease recurrence or invasion in PT, grouped according to role: (1) insensitivity to anti-growth signals: minichromosome maintenance protein 7; (2) evasion of the immune system: cyclooxygenase 2, arginase 1, programmed cell death protein 1 (PD-1)/programmed death ligand 2, cluster of differentiation (CD) 80/CD86; (3) sustained angiogenesis: endothelial cell-specific molecule, fibroblast growth factor receptor, matrix metalloproteinase 9, pituitary tumour transforming gene; (4) self-sufficiency in growth signals: epidermal growth factor receptor; and (5) tissue invasion: matrix metalloproteinase 9, fascin protein. Biomarkers with a negative correlation with disease recurrence or invasion include: (1) insensitivity to anti-growth signals: transforming growth factor β1, Smad proteins; (2) sustained angiogenesis: tissue inhibitor of metalloproteinase 1; (3) tissue invasion: Wnt inhibitory factor 1; and (4) miscellaneous: co-expression of glial fibrillary acidic protein and cytokeratin, and oestrogen receptors α36 and α66. PD-1/programmed cell death ligand 1 showed no clear association with invasion or recurrence, while cyclin A, cytotoxic T lymphocyte-associated protein 4, S100 protein, ephrin receptor, galectin-3 , neural cell adhesion molecule, protein tyrosine phosphatase 4A3 and steroidogenic factor 1 had no association with invasion or recurrence of PT. With the aim to develop a more personalized approach to the treatment of PT, and because of the limited number of molecular targets currently studied in the context of recurrent PT and invasion, a better understanding of the most relevant of these biomarkers by well-d esigned interventional studies will lead to a better understanding of the molecular profile of PT. This should also meet the increased need of treatable molecular targets.

垂体瘤(PTs)是第二大最常见的颅内肿瘤。虽然大多数垂体瘤表现为良性,但也可能具有侵袭性,并对治疗产生抗药性。本综述旨在报告最近发现的可能具有预后价值的生物标志物。与非侵袭性或非复发性垂体癌或正常垂体癌相比,评估侵袭性/复发性垂体癌的潜在预后生物标志物或治疗靶点的研究被纳入本综述。在纳入的 28 项研究中,对超过 911 例 PT 进行了评估。通过系统性检索发现了一些可能与PT疾病复发或侵袭呈正相关的生物标志物的表达,这些标志物根据作用进行了分组:(1)对抗生长信号不敏感:小染色体维护蛋白7;(2)逃避免疫系统:环氧化酶 2、精氨酸酶 1、程序性细胞死亡蛋白 1(PD-1)/程序性死亡配体 2、分化簇(CD)80/CD86;(3) 持续血管生成:内皮细胞特异性分子、成纤维细胞生长因子受体、基质金属蛋白酶 9、垂体瘤转化基因;(4) 生长信号自给自足:表皮生长因子受体;(5) 组织侵袭:基质金属蛋白酶 9、筋膜蛋白。与疾病复发或侵袭呈负相关的生物标志物包括(1) 对抗生长信号不敏感:转化生长因子 β1、Smad 蛋白;(2) 持续血管生成:金属蛋白酶组织抑制剂 1;(3) 组织侵袭:Wnt抑制因子1;(4) 其他:胶质纤维酸性蛋白和细胞角蛋白的共同表达,以及雌激素受体α36和α66。而细胞周期蛋白A、细胞毒性T淋巴细胞相关蛋白4、S100蛋白、ephrin受体、galectin-3、神经细胞粘附分子、蛋白酪氨酸磷酸酶4A3和类固醇生成因子1与PT的侵袭或复发无明显关联。为了开发更个性化的 PT 治疗方法,同时由于目前针对复发性 PT 和侵袭研究的分子靶点数量有限,通过精心设计的介入研究更好地了解这些生物标志物中最相关的生物标志物将有助于更好地了解 PT 的分子特征。这也将满足对可治疗分子靶点的更多需求。
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引用次数: 0
The Clinical Septet of Van Wyk-Grumbach Syndrome: A Case Series from a Tertiary Care Centre in Kalyana Karnataka, India. Van Wyk-Grumbach综合征的临床特征:来自印度卡纳塔克邦Kalyana三级保健中心的病例系列。
Pub Date : 2023-05-01 DOI: 10.17925/EE.2023.19.1.98
Swaraj Waddankeri, Meenakshi Waddankeri, Shrikant Waddankeri, Kshitij Arora

Van Wyk-Grumbach syndrome is a rare, female juvenile hypothyroidism disorder that is characterized by precocious puberty with clinical, radiological and hormonal pathologies. We present a case series of three patients with this unusual condition who were evaluated and followed up over a 3-year period between January 2017 and June 2020. All three patients presented with short stature (<3rd centile), low weight (<3rd centile), absence of goitre, no axillary or pubic hair, delayed bone age by more than 2 years, elevated thyroid-stimulating hormone with low T3 and T4 (primary hypothyroidism), and raised follicle-stimulating hormone with pre-pubertal levels of luteinizing hormone. Abdominal ultrasonography showed bilateral multi-cystic ovaries in two patients and a right-sided bulky ovary in the third patient. One of the patients also had a pituitary 'macroadenoma'. All the patients were successfully managed with levothyroxine. We discuss the pathophysiological mechanisms with a brief literature review.

Van Wyk-Grumbach综合征是一种罕见的女性青少年甲状腺功能减退症,以性早熟为特征,伴有临床、放射学和激素病理学。我们提出了一个由三名患有这种不寻常疾病的患者组成的病例系列,他们在2017年1月至2020年6月的3年期间进行了评估和随访。三名患者均表现为身材矮小(
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引用次数: 0
Thyrotoxic Cardiomyopathy: State of the Art. 甲亢性心肌病:最新进展
Pub Date : 2023-05-01 Epub Date: 2023-02-07 DOI: 10.17925/EE.2023.19.1.78
Juan Eduardo Quiroz-Aldave, María Del Carmen Durand-Vásquez, Carlos Jhonatan Lobato-Jeri, Juan-Manuel Muñoz-Moreno, Diana Carolina Deutz Gómez Condori, Sofía Pilar Ildefonso-Najarro, Felipe Contreras-Yametti, Francisca Zavaleta-Gutiérrez, Luis Concepción-Urteaga, Marcio José Concepción-Zavaleta

Thyroid hormones, mainly triiodothyronine, have genomic and non-genomic effects on cardiomyocytes related to the contractile function of the heart. Thyrotoxicosis, which is the set of signs and symptoms derived from the excess of circulating thyroid hormones, leads to increased cardiac output and decreased systemic vascular resistance, increasing the volume of circulating blood and causing systolic hypertension. In addition, the shortening of the refractory period of cardiomyocytes produces sinus tachycardia and atrial fibrillation. This leads to heart failure. Approximately 1% of patients with thyrotoxicosis develop thyrotoxic cardiomyopathy, a rare but potentially fatal form of dilated cardiomyopathy. Thyrotoxic cardiomyopathy represents a diagnosis of exclusion, and prompt identification is crucial as it is a reversible cause of heart failure, and heart function can be recovered after achieving a euthyroid state using antithyroid drugs. Radioactive iodine therapy and surgery are not the best initial therapeutic approach. Moreover, it is important to manage cardiovascular symptoms, for which beta blockers are the first-line therapeutic option.

甲状腺激素,主要是三碘甲状腺原氨酸,对与心脏收缩功能有关的心肌细胞具有基因组和非基因组效应。甲亢是循环中甲状腺激素过量引起的一系列症状和体征,会导致心输出量增加,全身血管阻力降低,循环血量增加,引起收缩期高血压。此外,心肌细胞的折返期缩短会产生窦性心动过速和心房颤动。这会导致心力衰竭。约有1%的甲亢患者会发生甲亢性心肌病,这是一种罕见但可能致命的扩张型心肌病。甲亢性心肌病是一种排除性诊断,及时发现至关重要,因为它是心力衰竭的可逆性病因,在使用抗甲状腺药物达到甲状腺功能亢进状态后,心脏功能可以恢复。放射性碘治疗和手术并非最佳的初始治疗方法。此外,控制心血管症状也很重要,β受体阻滞剂是一线治疗方案。
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引用次数: 0
Surgical Treatment of Solitary Metachronous Adrenal Metastasis from Urothelial Carcinoma of the Urinary Bladder. 膀胱尿路上皮癌单发异时性肾上腺转移的手术治疗。
Pub Date : 2023-05-01 DOI: 10.17925/EE.2023.19.1.94
Dimitrios Politis, Panagiota Konstantakou, Konstantinos Bramis, Krystallenia I Alexandraki, Ariadni Spyroglou, George Mastorakos, Ioannis Anastasiou, Ioannis Papaconstantinou, Meletios A Dimopoulos

Urothelial cancer is a common neoplasm and metastatic disease correlates with a poor prognosis. Isolated adrenal gland metastases of urothelial carcinoma are quite rare, and management options can decide a patient's prognosis. Herein we report the case of a 76-year-old man with a metachronous solitary adrenal metastasis from a bladder carcinoma, who underwent adrenalectomy as part of his treatment. Furthermore, we discuss the cases of solitary adrenal metastases of urothelial carcinoma available in the literature, to identify key features to direct appropriate treatment of this rare metastatic site of urothelial cancer and improve prognosis and survival. Still, further prospective studies are needed to design effective therapeutic strategies.

尿路上皮癌是一种常见的肿瘤和转移性疾病,预后较差。孤立的肾上腺转移的尿路上皮癌是相当罕见的,治疗方案可以决定病人的预后。我们在此报告一名76岁男性膀胱癌异时性孤立性肾上腺转移的病例,他接受了肾上腺切除术作为治疗的一部分。此外,我们讨论了文献中可用的尿路上皮癌单发肾上腺转移的病例,以确定关键特征,指导这种罕见的尿路上皮癌转移部位的适当治疗,改善预后和生存率。然而,需要进一步的前瞻性研究来设计有效的治疗策略。
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引用次数: 0
Coexistence of Thyrolipomatosis and Tongue Squamous Cell Carcinoma: A Case Report. 甲状腺脂肪瘤病与舌鳞癌共存1例。
Pub Date : 2023-05-01 DOI: 10.17925/EE.2023.19.1.103
Jose Paz-Ibarra, Marcio Concepción-Zavaleta, Daniel Mendoza-Quispe, Jacsel Suárez-Rojas, Katia Rivera Fabián, Diana Deutz-Gómez, Juan Quiroz-Aldave, José Somocurcio Peralta, Tula Ayquipa Arróspide

Thyrolipomatosis, a diffuse non-neoplastic infiltration of fatty tissue in the thyroid gland, is an extremely rare condition with only about 30 cases reported worldwide. A few of these cases report the concurrency of thyrolipomatosis and malignant neoplasms in the thyroid or colon, but never with tongue cancer. A 44-year-old female patient with an infiltrative tongue mass suggestive of carcinoma presented for an outpatient consultation. Cervical imaging revealed multiple lymphadenopathies and a multinodular goitre with diffuse fatty infiltration, suggestive of thyrolipomatosis. Surgical intervention included partial resection of the tongue and thyroid (left hemiglossectomy and right hemithyroidectomy, respectively) and lymphadenectomy. The thyroid specimen showed diffuse fat metaplasia of the stromal thyroid tissue, confirming incidental thyrolipomatosis. During post-operative follow-up, the patient presented with recurrence of squamous cell carcinoma as indicated by new right-sided thyroid nodules, left-sided lymphadenopathies with confirmatory biopsy, and a growing neck mass that became infected. The patient developed septic shock and later died. Thyrolipomatosis causes thyroid swelling and can be clinically detected as goitres or as an incidental finding. Diagnosis is suggested by cervical imaging (ultrasonography, computed tomography or magnetic resonance), but confirmation is histological after thyroidectomy. Although thyrolipomatosis is benign, it could develop concurrently with neoplastic diseases, especially on embryologically related tissues (e.g. thyroid and tongue). This case report is the first in the literature describing the coexistence between thyrolipomatosis and tongue cancer in an adult Peruvian patient.

甲状腺脂肪瘤病是一种甲状腺脂肪组织的弥漫性非肿瘤性浸润,是一种极其罕见的疾病,全世界仅报道了约30例。这些病例中有少数报告甲状腺脂肪瘤病和甲状腺或结肠恶性肿瘤的并发,但从未报告舌癌。一个44岁的女性患者浸润性舌肿块提示癌提出门诊咨询。宫颈影像显示多发性淋巴结病变及弥漫性脂肪浸润的多结节性甲状腺肿,提示甲状腺脂肪瘤病。手术干预包括舌和甲状腺部分切除(分别为左侧半胱氨酸切除术和右侧半甲状腺切除术)和淋巴结切除术。甲状腺标本显示甲状腺间质组织弥漫性脂肪化生,证实偶发性甲状腺脂肪瘤病。在术后随访中,患者出现鳞状细胞癌复发,表现为右侧新发甲状腺结节,左侧淋巴结病变,活检证实,颈部肿块不断扩大并感染。病人出现感染性休克,后来死亡。甲状腺脂肪瘤病引起甲状腺肿胀,临床上可作为甲状腺肿或偶然发现。诊断建议通过宫颈影像学检查(超声、计算机断层扫描或磁共振),但在甲状腺切除术后需要组织学证实。虽然甲状腺脂肪瘤病是良性的,但它可以并发肿瘤疾病,特别是胚胎相关组织(如甲状腺和舌)。本病例报告是文献中第一个描述甲状腺脂肪瘤病和舌癌共存的秘鲁成年患者。
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引用次数: 0
The AACE 2022 Guideline: An Academic Appraisal. AACE 2022指南:学术评估。
Pub Date : 2023-05-01 DOI: 10.17925/EE.2023.19.1.2
Saptarshi Bhattacharya, Sanjay Kalra

The American Association of Clinical Endocrinology (AACE) 2022 guideline provides comprehensive and evidence-based guidance on contemporary diabetes management. The statement reiterates the importance of person-centred, team-based care for optimum outcomes. The recent strides to prevent cardiovascular and renal complications have been aptly incorporated. The recommendations on virtual care, continuous glucose monitors, cancer screening, infertility and mental health are relevant. However, focused discussions on non-alcoholic fatty liver disease and geriatric diabetes care could have been helpful. Outlining targets for prediabetes care is a notable addition and is likely to be the most effective strategy in addressing the rising burden of diabetes.

美国临床内分泌学会(AACE) 2022指南为当代糖尿病管理提供了全面的循证指导。声明重申了以人为本、以团队为基础的护理对最佳结果的重要性。最近在预防心血管和肾脏并发症方面取得的进展已被适当地纳入。关于虚拟护理、连续血糖监测、癌症筛查、不孕症和精神健康的建议是相关的。然而,集中讨论非酒精性脂肪性肝病和老年糖尿病的护理可能会有所帮助。概述糖尿病前期护理的目标是一个值得注意的补充,可能是解决糖尿病日益增加的负担的最有效策略。
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引用次数: 0
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TouchREVIEWS in endocrinology
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