scholarly journals CONSENSUS STATEMENT BY THE AMERICAN ASSOCIATION OF CLINICAL ENDOCRINOLOGISTS AND AMERICAN COLLEGE OF ENDOCRINOLOGY ON THE COMPREHENSIVE TYPE 2 DIABETES MANAGEMENT ALGORITHM – 2020 EXECUTIVE SUMMARY

2020 ◽  
Vol 26 (1) ◽  
pp. 107-139 ◽  
Author(s):  
Alan J. Garber ◽  
Yehuda Handelsman ◽  
George Grunberger ◽  
Daniel Einhorn ◽  
Martin J. Abrahamson ◽  
...  

Abbreviations: A1C = hemoglobin A1C; AACE = American Association of Clinical Endocrinologists; ABCD = adiposity-based chronic disease; ACCORD = Action to Control Cardiovascular Risk in Diabetes; ACCORD BP = Action to Control Cardiovascular Risk in Diabetes Blood Pressure; ACE = American College of Endocrinology; ACEI = angiotensin-converting enzyme inhibitor; AGI = alpha-glucosidase inhibitor; apo B = apolipoprotein B; ARB = angiotensin II receptor blocker; ASCVD = atherosclerotic cardiovascular disease; BAS = bile acid sequestrant; BMI = body mass index; BP = blood pressure; CCB = calcium channel blocker; CGM = continuous glucose monitoring; CHD = coronary heart disease; CKD = chronic kidney disease; DKA = diabetic ketoacidosis; DPP4 = dipeptidyl peptidase 4; eGFR = estimated glomerular filtration rate; EPA = eicosapentaenoic acid; ER = extended release; FDA = Food and Drug Administration; GLP1 = glucagon-like peptide 1; HDL-C = high-density-lipoprotein cholesterol; HeFH = heterozygous familial hypercholesterolemia; LDL-C = low-density-lipoprotein cholesterol; LDL-P = low-density-lipoprotein particle; Look AHEAD = Look Action for Health in Diabetes; NPH = neutral protamine Hagedorn; OSA = obstructive sleep apnea; PCSK9 = proprotein convertase subtilisin-kexin type 9 serine protease; RCT = randomized controlled trial; SU = sulfonylurea; SGLT2 = sodium-glucose cotransporter 2; SMBG = self-monitoring of blood glucose; T2D = type 2 diabetes; TZD = thiazolidinedione

Author(s):  
Yuto Saijo ◽  
Hiroshi Okada ◽  
Masahide Hamaguchi ◽  
Momoko Habu ◽  
Kazushiro Kurogi ◽  
...  

(1) Background: As no study has evaluated the risk factors contributing to the development of type 2 diabetes according to body weight mass (BMI) categories in a large cohort and over a long period in a Japanese population, we aimed to assess them in 46,001 Japanese individuals; (2) Methods: This long-term retrospective cohort study included individuals who participated in a medical health checkup program at Panasonic Corporation from 2008 to 2018. In total, 3,208 participants developed type 2 diabetes. The BMI at 2008 were divided into 3 groups: BMI < 22 kg/m2, 22 ≤ BMI < 25 kg/m2, and BMI ≥ 25 kg/m2 to evaluate the risk factors for type 2 diabetes; (3) Results: Cox regression analyses revealed that the significant risk factors were age, BMI, systolic blood pressure, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, triglycerides, fasting plasma glucose, current smoking status, and alcohol consumption in populations with BMI ≥ 25.0 kg/m2. The risk factors in the population with 22 ≤ BMI < 25 kg/m2 were identical to that of BMI ≥ 25.0 kg/m2 excluding systolic blood pressure, low-density lipoprotein cholesterol, and skipping breakfast. However, in the population with BMI < 22.0 kg/m2, no association was found as to BMI, SBP, LDL cholesterol level, and triglycerides; (4) Conclusions: The risk factors for developing diabetes were quite different between the population with BMI < 22 kg/m2 and the population with 22 ≤ BMI < 25 kg/m2 or BMI ≥ 25 kg/m2 in a Japanese population.


2020 ◽  
pp. 263246362097804
Author(s):  
Rejitha Jagesh ◽  
Mathew John ◽  
Manju Manoharan Nair Jalaja ◽  
Tittu Oommen ◽  
Deepa Gopinath

Objectives: The accurate and precise measurement of low-density lipoprotein-cholesterol (LDL-C) is important in the assessment of atherosclerotic cardiovascular disease risk (ASCVD) in people with diabetes mellitus. This study aimed at comparing directly measured LDL-C with Friedewald formula (FF)-calculated LDL-C (c-LDL-C) in people with type-2 diabetes. Methods: Fasting lipid profiles of 1905 people with type-2 diabetes, whose LDL-C was estimated by direct LDL assay, were chosen for the study. In the same group, LDL-C was calculated with FF. Correlation and agreement between these methods were analyzed at various strata of triglycerides (TGs). The possibility of misclassifying people at various levels of LDL-C targets proposed in literature was calculated. Results: The mean LDL-C levels were lower in the c-LDL-C group across various TG strata. A significant correlation was found between c-LDL-C and direct LDL-C for all the study samples ( r = 0.948, P < .001) and across all TG strata. Analysis of agreement showed a positive bias for direct LDL-C which increased at higher strata of TGs. c-LDL-C underestimated ASCVD by misclassifying people at various LDL-C target levels. Conclusion: There is a difference between direct LDL-C and c-LDL-C values in people with diabetes and this may result in misclassifying ASCVD especially at lower levels of LDL-C and higher levels of TGs.


2018 ◽  
Vol 26 (2) ◽  
pp. 140-147
Author(s):  
Nahid Yeasmin ◽  
Qazi Shamima Akhter ◽  
Sayeeda Mahmuda ◽  
Sultana Yeasmin ◽  
Rumana Afroz ◽  
...  

Background: Diabetes mellitus is one of the most widespread endocrine disorders in female and its complications are increasing all over the world, leading to life threatening medical problems like cardiovascular diseases, stroke and end stage renal diseases. A correlation between hyperlipidemia and type 2 diabetes mellitus has been identified. The study was carried out to observe the correlation of serum low density lipoprotein cholesterol (LDL-C) and high density lipoprotein cholesterol (HDL-C) level with type 2 diabetes mellitus in adult female subjects.Method: This cross sectional study was conducted in the Department of Physiology, Dhaka Medical College, Dhaka, during the period of January 2011 to December 2011. Total sixty female subjects were selected with age ranging from 30 to 50 years. Among them 30 female subjects with diabetes mellitus were included from out-patient department of Endocrinology, Dhaka Medical College Hospital, Dhaka as study group (B) and 30 apparently healthy females were taken as control group (A) for comparison. Estimation of serum fasting serum LDL-C and HDL-C levels was done by enzymatic method in the department of Physiology, Dhaka Medical College Dhaka in both groups. Fasting serum insulin level was measured by ELISA method in the laboratory of National Institute of ENT, Dhaka and fasting blood glucose was estimated by glucose oxidase method in the department of Physiology, Dhaka Medical College in both groups. Data were analyzed by Unpaired Student’s- test and Pearson’s correlation co-efficient (r) test as applicable.Results: The value of fasting serum LDL-C level was significantly higher in study subjects than those of control. Again, fasting serum HDL-C level was significantly lower in study subjects in comparison to controls. In study subjects fasting serum LDL showed positive correlation and fasting serum HDL-C levels showed negative correlation with fasting blood glucose and serum insulin level.Conclusion: Present study reveals that serum insulin and blood glucose level have positive relationship with low density lipoprotein cholesterol (LDL-C) and negative relationship with high density lipoprotein cholesterol (HDL-C) levels.J Dhaka Medical College, Vol. 26, No.2, October, 2017, Page 140-147


2019 ◽  
Vol 26 (8) ◽  
pp. 824-835 ◽  
Author(s):  
Kornelia Kotseva ◽  
Guy De Backer ◽  
Dirk De Bacquer ◽  
Lars Rydén ◽  
Arno Hoes ◽  
...  

Aims The aim of this study was to determine whether the Joint European Societies guidelines on secondary cardiovascular prevention are followed in everyday practice. Design A cross-sectional ESC-EORP survey (EUROASPIRE V) at 131 centres in 81 regions in 27 countries. Methods Patients (<80 years old) with verified coronary artery events or interventions were interviewed and examined ≥6 months later. Results A total of 8261 patients (females 26%) were interviewed. Nineteen per cent smoked and 55% of them were persistent smokers, 38% were obese (body mass index ≥30 kg/m2), 59% were centrally obese (waist circumference: men ≥102 cm; women ≥88 cm) while 66% were physically active <30 min 5 times/week. Forty-two per cent had a blood pressure ≥140/90 mmHg (≥140/85 if diabetic), 71% had low-density lipoprotein cholesterol ≥1.8 mmol/L (≥70 mg/dL) and 29% reported having diabetes. Cardioprotective medication was: anti-platelets 93%, beta-blockers 81%, angiotensin-converting enzyme inhibitors/angiotensin receptor blockers 75% and statins 80%. Conclusion A large majority of coronary patients have unhealthy lifestyles in terms of smoking, diet and sedentary behaviour, which adversely impacts major cardiovascular risk factors. A majority did not achieve their blood pressure, low-density lipoprotein cholesterol and glucose targets. Cardiovascular prevention requires modern preventive cardiology programmes delivered by interdisciplinary teams of healthcare professionals addressing all aspects of lifestyle and risk factor management, in order to reduce the risk of recurrent cardiovascular events.


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