Estrategia terapéutica en el paciente diabético (I). Empoderamiento del paciente y educación. Objetivos terapéuticos. Estilo de vida, alimentación y control de los factores de riesgo cardiovascular. Sistemas de control glucémico

  1. A. Bayona Cebada 1
  2. J. Boris Quiñones Silva 2
  3. Héctor Francisco Escobar Morreale 3
  4. Lía Nattero Chávez 4
  1. 1 Unidad de Diabetes, Servicio de Endocrinología y Nutrición, Hospital Universitario Ramón y Cajal, Madrid, España Servicio de Endocrinología y Nutrición, Hospital Universitario Ramón y Cajal, Madrid, España Grupo de Investigación en Diabetes, Obesidad y Reproducción Humana integrado en el CIBER de Diabetes y Enfermedades Metabólicas, Instituto de Salud Carlos III, Madrid, España Facultad de Medicina, Universidad de Alcalá, Alcalá de Henares, Madrid, España
  2. 2 Servicio de Endocrinología y Nutrición, Hospital Universitario Ramón y Cajal, Madrid, España
  3. 3 Servicio de Endocrinología y Nutrición, Hospital Universitario Ramón y Cajal, Madrid, España Grupo de Investigación en Diabetes, Obesidad y Reproducción Humana integrado en el CIBER de Diabetes y Enfermedades Metabólicas, Instituto de Salud Carlos III, Madrid, España
  4. 4 Unidad de Diabetes, Servicio de Endocrinología y Nutrición, Hospital Universitario Ramón y Cajal, Madrid, España Servicio de Endocrinología y Nutrición, Hospital Universitario Ramón y Cajal, Madrid, España Grupo de Investigación en Diabetes, Obesidad y Reproducción Humana integrado en el CIBER de Diabetes y Enfermedades Metabólicas, Instituto de Salud Carlos III, Madrid, España
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Journal:
Medicine: Programa de Formación Médica Continuada Acreditado

ISSN: 0304-5412

Year of publication: 2024

Issue Title: Enfermedades endocrinológicas y metabólicas (VII): Diabetes mellitus

Series: 14

Issue: 19

Pages: 1107-1115

Type: Article

DOI: 10.1016/J.MED.2024.10.010 DIALNET GOOGLE SCHOLAR

More publications in: Medicine: Programa de Formación Médica Continuada Acreditado

Abstract

Managing type 2 diabetes (DM2) requires a multifactorial approach. The foundation of treatment is lifestyle modification and diabetes education. Patients must be involved in decision making and be given tools to help them manage their disease. The four basic pillars of DM2 management are: a) glycemic control; b) blood pressure management; c) lipid management; and d) use of drugs with proven cardiovascular and renal benefits. In terms of lifestyle, it is recommended to combine a diet that contributes to weight maintenance and glycemic control as well as the incorporation of regular moderate physical activity (at least 150 minutes per week). Cholesterol and blood pressure targets should be individualized for each patient with DM2 based on the presence of cardiovascular disease or cardiovascular risk. Smoking cessation is recommended. There are two main glycemic control systems: blood glucose monitoring (capillary glycemia) and continuous glucose monitoring.

Bibliographic References

  • 1. M.A. Weber et al. ACCOMPLISH Investigators. Cardiovascular events during differing hypertension therapies in patients with diabetes. J Am Coll Cardiol. (2010)
  • 2. H.J. Yoo et al. Use of a real time continuous glucose monitoring system as a motivational device for poorly controlled type 2 diabetes. Diabetes Res Clin Pract. (2008)
  • 3. Wexler DJ, Nathan DM, Rubinow K. Initial management of hyperglycemia in adults with type 2 diabetes mellitus....
  • 4. American Diabetes Association Professional Practice Committee. 5. Facilitating positive health behaviors and well-being to improve health outcomes: Standards of care in diabetes-2024. Diabetes Care. (2024)
  • 5. D.G. Marrero et al. Twenty-first century behavioral medicine: a context for empowering clinicians and patients with diabetes: a consensus report. Diabetes Care. (2013)
  • 6. M.J. Davies et al. Management of hyperglycemia in type 2 diabetes, 2022. A consensus report by the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD). Diabetes Care. (2022)
  • 7. K. Pal et al. Computer-based diabetes self-management interventions for adults with type 2 diabetes mellitus. Cochrane Database Syst Rev. (2013)
  • 8. American Diabetes Association Professional Practice Committee. 10. Cardiovascular disease and risk management: Standards of care in diabetes-2024. Diabetes Care. (2024)
  • 9. R.R. Holman et al. 10-year follow-up of intensive glucose control in type 2 diabetes. N Engl J Med. (2008)
  • 10. R.A. Hayward et al. VADT Investigators. Follow-up of glycemic control and cardiovascular outcomes in type 2 diabetes. N Engl J Med. (2015)
  • 11. ADVANCE Collaborative Group et al. Intensive blood glucose control and vascular outcomes in patients with type 2 diabetes. N Engl J Med. (2008)
  • 12. Action to control cardiovascular risk in Diabetes Study Group et al. Effects of intensive glucose lowering in type 2 diabetes. N Engl J Med. (2008)
  • 13. A. Rawshani et al. Risk factors, mortality, and cardiovascular outcomes in patients with type 2 diabetes. N Engl J Med. (2018)
  • 14. United Kingdom Prospective Diabetes Study (UKPDS). 13: Relative efficacy of randomly allocated diet, sulphonylurea, insulin, or metformin in patients with newly diagnosed non-insulin dependent diabetes followed for three years. BMJ. (1995)
  • 15. D. Umpierre et al. Physical activity advice only or structured exercise training and association with HbA1c levels in type 2 diabetes: a systematic review and meta-analysis. JAMA. (2011)
  • 16. A.M. Egan et al. Barriers to exercise in obese patients with type 2 diabetes. QJM. (2013)
  • 17. Wexler DJ, Nathan DM, Rubinow K. Overview of general medical care in nonpregnant adults with diabetes mellitus....
  • 18. P. Gaede et al. Multifactorial intervention and cardiovascular disease in patients with type 2 diabetes. N Engl J Med. (2003)
  • 19. A.Z. Fan et al. Trends in cigarette smoking rates and quit attempts among adults with and without diagnosed diabetes, United States, 2001-2010. Prev Chronic Dis. (2013)
Data source: Dialnet