專題討論4:糖尿病、高血脂及心血管疾病

S4-3
2018 ADA治療指引看糖尿病治療的新概念
田凱仁
永康奇美醫院內分泌科

  The American Diabetes Association (ADA) released its 2018 Standards of Medical Care in Diabetes, and several of the new recommendations involved older adults with co-morbidities, including those with cardiovascular disease or hypertension as well as diabetes
  Individualized strategy is always mandatory in treating type 2 diabetes. Based upon the results of multiple cardiovascular outcome trials (CVOT), there are new treatment recommendations for adults with type 2 diabetes, suggesting a pathway for people with heart disease that, after lifestyle management and metformin, should include a medication validated to improve heart health. Evidence-based suggestions point out Empagliflozin, Canagliflozin and Liraglutide shows clinical CV beneficial effects in patients with ASCVD. A new section describes emerging evidence that speci?c glucose-lowering medications can delay the onset and progression of kidney disease.
  In addition, three new recommendations targeting older adults were added to highlight the importance of individualizing pharmacologic therapy to reduce the risk of hypoglycemia, avoid overtreatment and simplify complex regimens while maintaining personalized blood glucose targets