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[RR 0.75 (CI 95%: 0.60-0.93)], and in particular, due to the reduction of photocoagulation. Likewise, an insignificant tendency in the decrease of other events, such as AMI or amputations, was observed. The main adverse effect found was the imperative increase of severe hypoglycaemia stages; this is one of the reasons why glycemic aims must be individualised. Only 50% of the patients assigned to the intensive treatment, achieved figures below 7%. Therefore the HbA 1 c targets have to take into consideration the benefits of intensive control as regards the risk of hypoglycaemia, and the incovenience of the treatment for the patient and his family. The guidelines examined agree on the importance of glycemic targets for HbA 1 c between 6.5% and 7.5% mainly based on the aforementioned studies. An edition was issued recently on this matter in the main CPGs on diabetes (107). The authors state that targets below 7% for HbA 1 c are considered reasonable for many patients, though not for all. The target for the HbA 1 c level should be based on the individualised assessment of the risk for diabetes complications, comorbidity, life style and the patient’s preferences. The aims of the treatment should be set after having debated with the patient on the advantages and the risks of the specific levels of glycemic control. In general, lower HbA 1 c figures are recommended for patients with microalbuminuria within the context of a multifactorial intervention to reduce cardiovascular risk (108). Likewise, less strict levels can be appropriate for patients with limited life expectancy, comorbidity or a prior hypoglycaemia history (2). Recently, the ACCORD trial has compared strict glycemic control (HbA 1 c
4 The guidelines examined agree to state that HbA 1 c aims below 7% are for guidance (107). A more strict control is recommended for people with high cardiovascular risk (79) or microalbuminuria (108). 1+ Patients with long-term diabetes and high risk to have cardiovascular events, the HbA 1 c control
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Clinical Practice Guideline on type
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A bibliographic record of this work
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Table of Contents Presentation 9 Au
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11. Diabetic foot. Assessment, prev
Page 11: Presentation Care practice is becom
Page 14 and 15: Other collaborations Rosa Rico Itur
Page 16 and 17: 13. Which drug combination strategi
Page 19 and 20: Summary of recommendations Defi nit
Page 21 and 22: D CPG B B B B A daily single dose
Page 23 and 24: A B CPG Hypertense patients with DM
Page 25 and 26: Treatment for diabetic foot ulcers
Page 27: 1. Introduction Effective care for
Page 31 and 32: 3. Methodology Methodology. Evidenc
Page 33 and 34: 4. Epidemiology and sanitary impact
Page 35: However, the quality of the assista
Page 38 and 39: 5.2. Risk factors for the developme
Page 40 and 41: 5.2.8. Diet and alcohol Type of die
Page 42 and 43: 5.2.12. Heart failure The associati
Page 44 and 45: The ADA does not recommend it for c
Page 46 and 47: Figure 1. DM 2 diagnostic algorithm
Page 48 and 49: 46 CLINICAL PRACTICE GUIDELINES IN
Page 50 and 51: 6.1. Impaired Fating Glucoseucose (
Page 52 and 53: 1++ An intensive intervention on li
Page 54 and 55: Different SRs (81-84) have assessed
Page 56 and 57: 7.1.4. Other dietary interventions
Page 58 and 59: Exchange system This system is base
Page 60 and 61: duration and intensity). Performing
Page 64 and 65: The optimum dose in most patients i
Page 66 and 67: without heart failure. In this stud
Page 68 and 69: B B B B Metillinides can play a ro
Page 70 and 71: Recommendations B A A B B B B When
Page 72 and 73: 8.2. Insulin therapy 8.2.1. Associa
Page 74 and 75: Slow-acting insulin analogues vs. N
Page 77 and 78: 9. Screening and treatment of macro
Page 79 and 80: The validity and applicability of a
Page 81 and 82: The RCTs and the meta-analysis are
Page 83 and 84: 1+ In primary prevention, aspirin b
Page 85 and 86: 9.5.2. Pharmacological treatment of
Page 87: Recommendations B/D A B CPG Patient
Page 90 and 91: incidence was 0.3% after the first
Page 92 and 93: it is believed that microalbuminuri
Page 94 and 95: Summary of evidence 1++ In hyperten
Page 96 and 97: An SR on drugs to treat diabetic ne
Page 98 and 99: (241), the response rate to placebo
Page 101 and 102: 11. Diabetic foot. Assessment, prev
Page 103 and 104: 11.2.2. Peripheral arterial disease
Page 105 and 106: 11.4. Other preventive measures The
Page 107 and 108: B D CPG B Diabetic foot screening m
Page 109 and 110: 11.5.4. Antibiotic treatment for in
Page 111: 2+ The culture has a limited value
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• Promote healthy lifestyles: die
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In another recent RCT (289), sMBG w
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12.3. Contents and methods of an ed
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Assessment of self-management recor
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13.4. Referral criteria to medical
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Appendices Appendix 1. Levels of Ev
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Appendix 2. DM 2 diet Estimating ca
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CLINICAL PRACTICE GUIDELINE ON TYPE
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GPL-1 Analogues Biguanides Glitazon
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Devices FLEXPEN (Novo Nordisk): OPT
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Treatment for an unconscious patien
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Appendix 6. Assessment of macro- an
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Appendix 8. Use of monofilament Mon
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Indicators of final outcomes • Nu
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Impaired Glucose Tolerance (IGT): I
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IGT INSIGHT Trial IV LDL LH LIFE Tr
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Bibliography 1. Estrategia en diabe
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33. Iso H, Date C, Wakai K, Fukui M
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64. Screening for type 2 diabetes.
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97. Thomas DE, Elliott EJ, Naughton
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129. Lincoff AM, Wolski K, Nicholls
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157. Natarajan S, Liao Y, Cao G, Li
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185. de GG. Low-dose aspirin and vi
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214. Rahman M, Pressel S, Davis BR,
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245. NZGG. Management of type 2 dia
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279. Norris SL, Nichols PJ, Caspers
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