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U.S., European groups update diabetes care guidelines

Sunday April 22, 2012
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After several years of planning, discussion and review, the American Diabetes Association and European Association for the Study of Diabetes have published new guidelines for managing hyperglycemia in people with type 2 diabetes.

The new guidelines are less prescriptive than those previously in place, and call for a more patient-centered approach that allows for individual patient needs, preferences and tolerances, and takes into account differences in age and disease progression, according to a joint statement.

The need for a combined task force was driven by the "increasingly complex and to some extent controversial" nature of glycemic management for type 2 diabetes, the "widening array of pharmacological agents now available, mounting concerns about their potential adverse effects and new uncertainties regarding the benefits of intensive glycemic control on macrovascular complications," according to the statement.

The guidelines call for providing all patients with diabetes education, in an individual or group setting, focusing on dietary intervention and the importance of increased physical activity, as well as weight management when appropriate. They encourage developing individualized treatment plans built around a patientís specific symptoms, co-morbidities, age, weight, racial/ethnic/gender differences and lifestyles.

Having a more patient-centered focus better reflects the reality of what happens when a patient seeks diabetes treatment, said Vivian Fonseca, MD, president, Medicine & Science of the American Diabetes Association.

"The wide range of pharmacological choices, along with conflicting data about some of those choices, and differences in how patients respond to medications, makes it difficult to prescribe a single treatment regimen based on an algorithm that is designed to work for everyone," Fonseca said in a news release.

"Whatís more, patients may not be able to continue long-term with a treatment program that isnít working for them, whether itís because of side effects from the medication, issues of convenience or lifestyle, or even a matter of financial resources. Diabetes is a complex disease that manifests differently in different people, and the best way for one person to manage it may not work for someone else.

"If we encourage people to work with their healthcare providers to find an individualized personal plan that works well for them and fits their lifestyle and personal needs, it has a higher chance for success in controlling glucose and decreasing the risk of long-term complications."

The guidelines appeared April 19 on the website of the journal Diabetes Care. The guidelines are available as a PDF at http://bit.ly/HYBsS9.

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