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赶紧收藏!糖尿病十大指导原则 39份指南、声明和共识!

2018-09-27  渐近故乡时

这不仅是一份指导原则,更是一本指南索引,你想知道的,里面都能找到!


作者|鲸鱼

来源|医学界内分泌频道

 


 

 

Fig 1.1 《指导原则》在线发布于NIDDK并提供免费下载

 

本次发布的《指导原则》更新了2014年的老版本,更新过程中受到美国20家相关组织协会的支持,包括美国糖尿病学会(ADA)、美国临床内分泌医师协会(AACE)等。这一更新后版本反应了过去几年中不断发生变化的新证据,内容上强调了糖尿病患者自我管理教育和以患者为中心的管理共同决策的重要性,并增加了一条新原则:管理糖尿病患者的超重或肥胖问题

 

Fig 1.2 支持《指导原则》发布的20家组织协会

 

这一文件侧重于成人2型糖尿病的预防和管理,但也提供了部分有关1型糖尿病、妊娠糖尿病、儿童及青少年2型糖尿病和其他类型糖尿病的信息。这一版本的《指导原则》简介中指出,这份文件并不是官方指南,也不是系统的证据梳理、立场或共识声明,而是综合了各家指南中共同的意见,精炼地总结为10条原则并辅以相应阐述,展现出现今人们在糖尿病管理中的普遍认识,以指导糖尿病及糖尿病前期患者的诊疗。

 

接下来,就让我们看看这十大原则是什么!


 

  

Fig 2.1 糖尿病管理十大原则及中译

 

除了这10条指导原则之外,文件中还有许多有价值的表格及总结值得我们关注,包括糖尿病的危险因素、糖尿病的筛查和诊断标准、糖化血红蛋白(HbA1c)与血糖的换算等——简直是一文在手,高招我有!

 

Fig 2.2  2型糖尿病的危险因素


Fig 2.3 糖尿病前期和2型糖尿病的筛查诊断标准


Fig 2.4 妊娠糖尿病的筛查诊断标准


Fig 2.5 根据BMI的超重/肥胖分类


Fig 2.6 糖尿病药物对体重的影响


Fig 2.7 HbA1c水平或范围对应的平均血糖水平

 

看完了这些表格和总结是不是还有些意犹未尽?不怕!这只不过是“开胃小菜”,“主菜”还在后面呢!这份文件的每条指导原则之后均附有相应的指南供读者参考,并贴心地附上了下载链接。文件中总计有39份指南,可以说是集糖尿病指南之大成了!


 

 

虽然这份指南在Medscape上被一些临床医师诟病:“没有什么用处”[2]。的确,这十大原则都是些非常正确的“废话”。但是,这并不妨碍我们将这份文件当作一份指南的索引来使用——接下来就让我们看看这份文件里究竟列举了哪些指南!

 

序号

指南、立场声明与共识报告

链接

1

2013 AHA/ACC Guideline on Lifestyle Management to  Reduce Cardiovascular Risk: A Report of the American College of  Cardiology/American Heart Association Task Force on Practice Guidelines

https://www.ahajournals.org/doi/abs/10.1161/01.cir.0000437740.48606.d1

2

2013 AHA/ACC/TOS Guideline for the Management of  Overweight and Obesity in Adults: A Report of the American College of  Cardiology/American Heart Association Task Force on Practice Guidelines and  The Obesity Society

https://www.ahajournals.org/doi/abs/10.1161/01.cir.0000437739.71477.ee

3

American Academy of Family Physicians, American  Academy of Pediatrics, American College of Physicians, American Osteopathic  Association. Joint Principles of the Patient-Centered Medical Home. Patient Centered Primary Care Collaborative 2007.

https://www.aafp.org/dam/AAFP/documents/practice_management/pcmh/initiatives/PCMHJoint.pdf

4

American Association of Clinical Endocrinologists  and American College of Endocrinology – Clinical Practice Guidelines for  Developing a Diabetes Mellitus Comprehensive Care Plan – 2015

https://www.aace.com/files/dm-guidelines-ccp.pdf

5

American Association of Clinical Endocrinologists  and American College of Endocrinology Comprehensive Clinical Practice  Guidelines for Medical Care of Patients with Obesity. 2016.

https://www.aace.com/files/final-appendix.pdf

6

American College of Obstetricians and Gynecologists.  Women’s Prevention Services Initiative: Screening for Gestational Diabetes  Mellitus

https://www.womenspreventivehealth.org/recommendations/screening-for-gestational-diabetes-mellitus/

7

American College of Physicians. Hemoglobin A1c  Targets for Glycemic Control With Pharmacologic Therapy for Nonpregnant  Adults With Type 2 Diabetes Mellitus: A Guidance Statement Update. 2018.

http://annals.org/aim/fullarticle/2674121/hemoglobin-1c-targets-glycemic-control-pharmacologic-therapy-nonpregnant-adults-type

8

American College of Physicians. Oral Pharmacologic  Treatment of Type 2 Diabetes Mellitus: A Clinical Practice Guideline

http://annals.org/aim/fullarticle/1033354/oral-pharmacologic-treatment-type-2-diabetes-mellitus-clinical-practice-guideline

9

American Diabetes Association Standards of Care in  Diabetes—2018: Cardiovascular Disease and Risk Management

http://care.diabetesjournals.org/content/41/Supplement_1/S86

10

American Diabetes Association Standards of Medical  Care in Diabetes—2018: Obesity Management for the Treatment of Type 2  Diabetes

http://care.diabetesjournals.org/content/41/Supplement_1/S65

11

American Diabetes Association, American Cancer  Society. Diabetes and Cancer: A consensus report. 2010.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2890380/

12

American Diabetes Association, European Association  for the Study of Diabetes. Management of Hyperglycemia in Type 2 Diabetes: A  Patient-Centered Approach: Position Statement of the American Diabetes  Association (ADA) and the European Association for the Study of Diabetes  (EASD). 2012.  

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3357214/

13

American Diabetes Association. Psychosocial Care for People with Diabetes: A Position Statement of  the American Diabetes Association. 2016.

http://care.diabetesjournals.org/content/39/12/2126

14

American Diabetes Association. Standards of Care in  Diabetes—2018: Lifestyle Management

http://care.diabetesjournals.org/content/41/Supplement_1/S38

15

American Diabetes Association. Standards of Medical  Care in Diabetes—2018: Classification and Diagnosis of Diabetes

http://care.diabetesjournals.org/content/41/Supplement_1/S13

16

American Diabetes Association. Standards of Medical  Care in Diabetes—2018: Comprehensive Medical Evaluation and Assessment of  Comorbidities

http://care.diabetesjournals.org/content/41/Supplement_1/S28

17

American Diabetes Association. Standards of Medical  Care in Diabetes—2018: Glycemic Targets

http://care.diabetesjournals.org/content/41/Supplement_1/S55

18

American Diabetes Association. Standards of Medical  Care in Diabetes—2018: Improving Care a d Promoting Health in Populations

http://care.diabetesjournals.org/content/41/Supplement_1/S7

19

American Diabetes Association. Standards of Medical  Care in Diabetes—2018: Prevention or Delay of Type 2 Diabetes

http://care.diabetesjournals.org/content/41/Supplement_1/S51

20

American Geriatrics Society. Guidelines for Improving the Care of Older Adults with Diabetes  Mellitus: 2013 Update and Supplemental Information. 2013.

https://geriatricscareonline.org/ProductAbstract/guidelines-for-improving-the-care-of-the-older-adult-with-diabetes-mellitus-2013-update-and-supplemental-information/CL008/

21

Clinical Practice Guidelines for the Perioperative  Nutritional, Metabolic, and Nonsurgical Support of the Bariatric Surgery  Patient – 2013 Update: Cosponsored by American Association of Clinical  Endocrinologists, The Obesity Society, and American Society for Metabolic and  Bariatric Surgery

https://www.aace.com/files/publish-ahead-of-print-final-version.pdf

22

Consensus Statement by the American Association of  Clinical Endocrinologists and American College of Endocrinology on the  Comprehensive Type 2 Diabetes Management Algorithm – 2018 Executive Summary

https://www.aace.com/sites/all/files/diabetes-algorithm-executive-summary.pdf

23

Diabetes Self-management Education and Support in  Type 2 Diabetes. A Joint Position Statement of the American Diabetes  Association, the American Association of Diabetes Educators, and the Academy  of Nutrition and Dietetics. 2015.

https://www.diabeteseducator.org/docs/default-source/practice/practice-resources/position-statements/dsme_joint_position_statement_2015.pdf?sfvrsn=0

24

Endocrine Society. Diabetes Technology—Continuous Subcutaneous Insulin Infusion Therapy  and Continuous Glucose Monitoring in Adults. 2016.

https://academic.oup.com/jcem/article/101/11/3922/2764917

25

International Association of Diabetes and Pregnancy  Study Groups Recommendations on the Diagnosis and Classification of  Hyperglycemia in Pregnancy

http://care.diabetesjournals.org/content/33/3/676.long

26

Metabolic Surgery in the Treatment Algorithm for  Type 2 Diabetes: A Joint Statement by International Diabetes Organizations. 2016.

http://care.diabetesjournals.org/content/39/6/861

27

Pharmacological Management of Obesity: An Endocrine  Society Clinical Practice Guideline. 2015. Cosponsored by the European Society of Endocrinology and The Obesity Society.

https://academic.oup.com/jcem/article/100/2/342/2813109

28

Physical Activity/Exercise and Diabetes: A Position  Statement of the American Diabetes Association. 2016.

http://care.diabetesjournals.org/content/39/11/2065

29

Position of the Academy of Nutrition and Dietetics:  Interventions for the Treatment of Overweight and Obesity in Adults. 2016.

https://secure.jbs.elsevierhealth.com/action/getSharedSiteSession?redirect=https%3A%2F%2Fwww.andjrnl.org%2Farticle%2FS2212-2672%2815%2901636-6%2Fpdf&rc=0

30

Primary Prevention of Cardiovascular Disease and  Type 2 Diabetes in Patients at Metabolic Risk: An Endocrine Society Clinical  Practice Guideline

https://academic.oup.com/jcem/article/93/10/3671/2627256

31

The Obesity Society with the ACC/AHA Task Force on  Practice Guidelines. Guidelines (2013) for Managing Overweight and Obesity in  Adults

https://onlinelibrary.wiley.com/toc/1930739x/22/S2

32

U.S. Preventive Services Task Force. Final  Recommendation Statement: Healthful Diet and Physical Activity for Cardiovascular  Disease Prevention in Adults With Cardiovascular Risk Factors: Behavioral  Counseling. 2014.  

https://www.uspreventiveservicestaskforce.org/Page/Document/RecommendationStatementFinal/healthy-diet-and-physical-activity-counseling-adults-with-high-risk-of-cvd

33

Update on Prevention of Cardiovascular Disease in  Adults With Type 2 Diabetes Mellitus in Light of Recent Evidence: A  Scientific Statement From the American Heart Association and the American  Diabetes Association. 2015.

https://www.ahajournals.org/doi/abs/10.1161/cir.0000000000000230

34

USPSTF Final Recommendation Statement. Abnormal  Blood Glucose and Type 2 Diabetes Mellitus: Screening

https://www.uspreventiveservicestaskforce.org/Page/Document/RecommendationStatementFinal/screening-for-abnormal-blood-glucose-and-type-2-diabetes

35

USPSTF Final Recommendation Statement. Aspirin Use  to Prevent Cardiovascular Disease and Colorectal Cancer: Preventive  Medication

https://www.uspreventiveservicestaskforce.org/Page/Document/RecommendationStatementFinal/aspirin-to-prevent-cardiovascular-disease-and-cancer

36

USPSTF Final Recommendation Statement. Gestational  Diabetes Mellitus, Screening

https://www.uspreventiveservicestaskforce.org/Page/Document/RecommendationStatementFinal/gestational-diabetes-mellitus-screening

37

USPSTF Final Recommendation Statement. Statin Use  for the Primary Prevention of Cardiovascular Disease in Adults: Preventive  Medication

https://www.uspreventiveservicestaskforce.org/Page/Document/RecommendationStatementFinal/statin-use-in-adults-preventive-medication1

38

USPSTF Final Recommendation Statement. Tobacco  Smoking Cessation in Adults, Including Pregnant Women: Behavioral and  Pharmacotherapy Interventions

https://www.uspreventiveservicestaskforce.org/Page/Document/RecommendationStatementFinal/tobacco-use-in-adults-and-pregnant-women-counseling-and-interventions1

39

VA/DoD Clinical Practice Guideline for the  Management of Type 2 Diabetes Mellitus in Primary Care – 2017

https://www.healthquality.va.gov/guidelines/CD/diabetes/

 

 

一共39份,赶紧收好咯!

 

最后,附上这份文件的下载链接:

https://www.niddk.nih.gov/-/media/Files/Health-Information/Communication-Programs/NDEP/health-care-professionals/Guiding_Principles_Final.pdf?la=en

—————

Reference

[1] National Diabetes Education Program (NDEP), The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). (2018). Guiding Principles for the Care of People With or at Risk for Diabetes.

Available at: 

https://www.niddk.nih.gov/-/media/Files/Health-Information/Communication-Programs/NDEP/health-care-professionals/Guiding_Principles_Final.pdf?la=en 

Last assessed on 2018-08-26.

[2] Miriam E. Tucker. NIDDK Updates ''Guiding Principles'' for Diabetes, Prediabetes. Medscape.  August 23, 2018. 

Available at: 

https://www.medscape.com/viewarticle/901127  

Last assessed on 2018-08-26. 


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