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NEW ORLÉE – Simplification of treatment regimens and personalization of glycemic targets in older people with diabetes improve adherence to treatment and avoid treatment-related complications, according to a clinical practice guideline released today. by the Society of Endocrinology. The Company made this recommendation at a press conference on the opening day of ENDO 2019, its annual meeting in New Orleans, Louisiana.
The guideline titled "Treatment of Diabetes in Older Adults: Clinical Practice Guideline of the Society of Endocrinology" was published online and will be published in the May 2019 print edition of the Journal of Clinical Endocrinology & Metabolism (JCI Monaco), publication of the Endocrine Society. The guideline focuses on treatment strategies that take into account the overall health and quality of life of older people with diabetes, defined as those aged 65 or older.
Aging plays a major role in the development of diabetes, which currently affects about 33% of older people in the United States. Older people with diabetes often suffer from one or more concomitant conditions such as cognitive impairment, cardiovascular disease, impaired vision, and rheumatoid arthritis. arthritis, which affects the self-management of diabetes.
"The recommendation encourages clinicians to take into account the available evidence and the general health status of a patient, the likelihood of benefiting from interventions and personal values when considering the patient. 39; therapeutic goals such as blood sugar, blood pressure and cholesterol, "said Derek LeRoith, MD, Ph.D., of Mount Sinai School of Medicine in New York, NY LeRoith chaired the editorial board that the directive. "Our framework prioritizes blood glucose targets compared to the A1c hemoglobin test for the management of diabetes in the elderly."
Guideline recommendations include:
- Simplify drug regimes and adjust glycemic targets in older people with diabetes and cognitive impairment (eg, dementia) to improve adherence and prevent treatment-related complications
- Design outpatient diabetes treatment regimens specifically to minimize hypoglycemia
- Target blood pressure levels of 140/90 mmHg to reduce the risk of cardiovascular disease, stroke and chronic progressive renal failure in elderly people with diabetes and aged 65 to 85 years
- Use an annual lipid profile to reduce the amount of "bad cholesterol" in your blood
- Annual administration of comprehensive eye examinations for retinal diseases
- Establish clear blood glucose targets for elderly diabetics in hospitals or nursing homes at 100-140 mg / dL (5.55-7.77 mmol / L) on an empty stomach and 140-180 mg / dL (7 , 77-10 mmol / L) after meals while avoiding hypoglycemia
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Other members of the editorial board of the Endocrine Society who drafted this directive include: Geert Jan Biessels of the Utrecht University Medical Center in Utrecht, the Netherlands; Susan S. Braithwaite of Presence St. Francis Hospital in Evanston, Ill. And Presence Saint Joseph Hospital in Chicago, Ill .; Felipe F. Casanueva of Complejo de Santiago University Hospital (CHUS), CIBER of Fisiopatologia Obesidad y Nutricion (CIBERobn), Instituto Salud Carlos III in Santiago de Compostela, Spain; Boris Draznin of the Anschutz Medical Campus of the University of Colorado at Aurora, Colorado; Jeffrey B. Halter of the University of Michigan at Ann Arbor, Michigan and the National University of Singapore; Irl B. Hirsch of the Medical Center of the University of Washington in Seattle, Washington; Marie E. McDonnell of Brigham and Women's Hospital and Harvard Medical School in Boston, Mbadachusetts; Mark E. Molitch of the Feinberg School of Medicine, Northwestern University, Chicago, Illinois; Mr. Hbadan Murad of the Mayo Clinic, Division of Preventive Medicine in Rochester, Min .; and Alan J. Sinclair of King's College in London, UK.
The Company has established its Clinical Practice Guidelines Program to provide endocrinologists and other clinicians with evidence-based recommendations for the diagnosis, treatment and management of endocrine-related conditions. Each guideline is developed by an editorial board composed of subject matter experts. Editorial boards rely on factual badyzes of the literature to develop recommendations. The Society of Endocrinology does not solicit nor accept the support of the company for its directives. All clinical practice guidelines are fully supported by the funds of the company.
This clinical practice guideline was co-sponsored by the European Society of Endocrinology, the Society of Gerontology of America and the Society of Obesity.
Endocrinologists are at the heart of solving the most pressing health problems of our time, from diabetes and obesity to infertility, bone health and hormone-related cancers. The Endocrine Society is the world's oldest and largest organization of scientists dedicated to hormone research and doctors who treat people with hormone-related disorders.
The Society has more than 18,000 members, including scientists, doctors, educators, nurses and students from 122 countries. To find out more about the Company and the field of endocrinology, visit our website at http://www.nrc.gov.on.ca.
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