Management of Type 2 Diabetes Mellitus (6th Edition) 2020: 5.62 MB: 465 KB : Management of Thyroid Disorders: 2019: 1.25 MB: 1.22 MB : Management of Diabetes in Pregnancy: 2017: 2.89 MB: 1.86 MB: 17.4 MB : Management of Type 1 Diabetes … Found insideBuilt on the foundation of multiple daily insulin injections and insulin pump therapy, this book guides health care providers in helping their patients continually strive for optimal blood glucose control. While hypoglycemia is associated with increased mortality, it may be a marker of underlying disease rather than the cause of fatality. Patients found to have elevated blood pressure (≥140/90 mmHg) should have blood pressure confirmed using multiple readings, including measurements on a separate day, to diagnose hypertension. A Other oral and noninsulin injectable glucose-lowering medications lack long-term safety data. The Standards of Medical Care in Diabetes—2021 provides the latest in comprehensive, evidence-based recommendations for the … Recently, several groups have developed algorithms to predict episodes of hypoglycemia among inpatients. NOTE: We only request your email address so that the person you are recommending the page to knows that you wanted them to see it, and that it is not junk mail. 1.1 Ensure treatment decisions are timely, rely on evidence-based guidelines, and are made collaboratively with patients based on individual preferences, prognoses, and comorbidities. A, 1.3 Care systems should facilitate team-based care and utilization of patient registries, decision support tools, and community involvement to meet patient needs. 6.6 An A1C goal for many nonpregnant adults of <7% (53 mmol/mol) is appropriate. 15.8 A hypoglycemia management protocol should be adopted and implemented by each hospital or hospital system. Pharmacologic Approaches to Glycemic Treatment of Type 2 Diabetes: Synopsis of the 2020 American Diabetes Association's Standards of Medical Care in Diabetes Clinical Guideline Ann Intern Med . Diabetes Advocacy” in the complete 2020 Standards of Care. A, 10.32 Statin plus fibrate combination therapy has not been shown to improve ASCVD outcomes and is generally not recommended. © 2019 by the American Diabetes Association. 2014 evidence-based guideline … Referral to a registered dietitian nutritionist (RD/RDN) is essential to assess the overall nutrition status of, and to work collaboratively with, the patient to create a personalized meal plan that coordinates and aligns with the overall treatment plan, including physical activity and medication use. A, 11.11 Promptly refer to a physician experienced in the care of kidney disease for uncertainty about the etiology of kidney disease, difficult management issues, and rapidly progressing kidney disease. A, 10.35 For patients with ASCVD and documented aspirin allergy, clopidogrel (75 mg/day) should be used. Postgrad Med 2019; 131: 251–260. Comprehensive Medical Evaluation and Assessment of Comorbidities” in the complete 2020 Standards of Care for discussion on these topics. B, 7.3 When prescribed as part of a DSMES program, SMBG may help to guide treatment decisions and/or self-management for patients taking less frequent insulin injections. A—Clear evidence from well-conducted, generalizable randomized controlled trials that are adequately powered, B—Supportive evidence from well-conducted cohort studies, C—Supportive evidence from poorly controlled or uncontrolled studies, E—Expert consensus or clinical experience. B, 12.2 Screen for geriatric syndromes (i.e., polypharmacy, cognitive impairment, depression, urinary incontinence, falls, and persistent pain) in older adults as they may affect diabetes self-management and diminish quality of life. INTRODUCTION — Treatment of patients with type 2 diabetes mellitus includes education, evaluation for micro- and macrovascular complications, attempts to achieve near normoglycemia, minimization of cardiovascular and other long-term risk factors, and avoidance of drugs that can exacerbate abnormalities of insulin or lipid metabolism. E, 6.15 Insulin-treated patients with hypoglycemia unawareness, one level 3 hypoglycemic event, or a pattern of unexplained level 2 hypoglycemia should be advised to raise their glycemic targets to strictly avoid hypoglycemia for at least several weeks in order to partially reverse hypoglycemia unawareness and reduce risk of future episodes. Found insideThe purpose of this book is to cover the recommended types and quantities of physical activities that can and should be undertaken by all individuals with any type of diabetes, along with precautions related to medication use and diabetes ... This presented a unique challenge as we tried to develop a guideline that is sensitive to resource and cost-effectiveness issues. ���ikp�́d�s&��h&�VhH&. Diabetes self-management in the hospital may be appropriate for selected patients. This guideline covers care and management for adults (aged 18 and over) with type 2 diabetes. B. Found insideCurr HIV/AIDS Rep 15(4):293–301, 2018 29968173 Kaiser Permanente: Type 2 Diabetes Screening and Treatment Guideline. Kaiser Permanente Clinical Guidelines, ... TYPE 2 INJECTED MEDICATIONS Amylin (no generic available) Slows food moving through the stomach. Risk of CKD progression, frequency of visits, and referral to nephrology according to GFR and albuminuria. B, Evaluate for diabetes complications and potential comorbid conditions. DSME and ongoing support are vital components of diabetes care for older adults and their caregivers. B, 11.16 If there is no evidence of retinopathy for one or more annual eye exams and glycemia is well controlled, then screening every 1–2 years may be considered. h�d��j�0�_eo��W���&��*H.��Xj"ް���uho�
�|3c�ժl�|!_�=��i:_d�a��@c�g/�'�q�m�C���Z .�R3j��k�#�{N3 ua Older adults (>65 years) with diabetes are at risk of developing a similar spectrum of microvascular complications as their younger counterparts, albeit probably at lower absolute risk if they develop diabetes later in life, which … OBESITY MANAGEMENT FOR THE TREATMENT OF TYPE 2 DIABETES, 9. 2019 update to: Management of hyperglycaemia in type 2 dibetes, 2018. 10.7 For patients with blood pressure >120/80 mmHg, lifestyle intervention consists of weight loss if they have overweight or obesity, a Dietary Approaches to Stop Hypertension (DASH)-style eating pattern including reducing sodium and increasing potassium intake, moderation of alcohol intake, and increased physical activity. 2 … A, 10.11 Multiple-drug therapy is generally required to achieve blood pressure targets. American Diabetes Association. A, 13.64 Youth with marked hyperglycemia (blood glucose ≥250 mg/dL [13.9 mmol/L], A1C ≥8.5% [69 mmol/mol]) without acidosis at diagnosis who are symptomatic with polyuria, polydipsia, nocturia, and/or weight loss should be treated initially with basal insulin while metformin is initiated and titrated. The guideline recommends how to support children and young people and their families and carers to maintain tight control of blood glucose to reduce the long-term risks associated with diabetes. B, 3.4 Based on patient preference, technology-assisted diabetes prevention interventions may be effective in preventing type 2 diabetes and should be considered. It should be assessed and managed by adjusting glycemic targets and pharmacologic regimens. 2021 Jan;9(1):46-52. doi: 10.1016/S2213-8587(20)30343-0. To make CGM metrics more actionable, standardized reports with visual cues such as the AGP (Figure 6.1) are recommended and may help patients and providers interpret the data and use it to guide treatment decisions. A, 9.10 In patients with type 2 diabetes who need greater glucose lowering than can be obtained with oral agents, GLP-1 receptor agonists are preferred to insulin when possible. 1 The prevalence of prediabetes and diabetes are higher in older adults. E, 5.33 Providers should consider assessment for symptoms of diabetes distress, depression, anxiety, disordered eating, and cognitive capacities using appropriate standardized and validated tools at the initial visit, at periodic intervals, and when there is a change in disease, treatment, or life circumstance. This new second edition updates all of the protocols and guidelines for treatment and medications and adds more information to aid with patient medical assessments, and clearly organizes individual conditions under three headings: ... Found inside"The goal of this practice guideline is to improve the quality of care and treatment outcomes for patients with schizophrenia. 8. ASCVD—defined as coronary heart disease, cerebrovascular disease, or peripheral arterial disease (PAD) presumed to be of atherosclerotic origin—is the leading cause of morbidity and mortality for individuals with diabetes. A. It also predicts that the prevalence of diabetes will increase from 4.5% in 2007 to 5.9% of the population in 20202. C, 6.12 Glucose (15–20 g) is the preferred treatment for the conscious individual with blood glucose <70 mg/dL [3.9 mmol/L]), although any form of carbohydrate that contains glucose may be used. The main adverse effect is an increased risk of gastrointestinal bleeding. B, 6.9 Reassess glycemic targets over time based on the criteria in Figure 6.2. This guideline is based on a systematic evidence review evaluating literature published on type 2 diabetes mellitus (T2DM). 1 … Following scheduled review, the KP Washington Type 1 Diabetes Guideline team determined that there were no outstanding evidence gaps and re-approved the guideline with only minor changes to content. INTRODUCTION — The prevalence of type 2 diabetes continues to increase steadily as more people live longer and grow heavier. B, 11.6 For people with nondialysis-dependent CKD, dietary protein intake should be approximately 0.8 g/kg body weight per day (the recommended daily allowance). 3.2 Refer patients with prediabetes to an intensive behavioral lifestyle intervention program modeled on the Diabetes Prevention Program (DPP) to achieve and maintain 7% loss of initial body weight and increase moderate-intensity physical activity (such as brisk walking) to at least 150 min/week. Diabetes Care 2020;43(Suppl. ***Dihydropyridine CCB. Nearly all of these FDA-approved medications have been found to improve glycemic control in patients with type 2 diabetes and delay progression to type 2 diabetes in patients at risk. See http://www.diabetesjournals.org/content/license for details. Once SMBG returns to normal, the individual should consume a meal or snack to prevent recurrence of hypoglycemia. In addition, diabetes in pregnancy may increase the risk of obesity, hypertension, and type 2 diabetes in offspring later in life. B, 1.2 Align approaches to diabetes management with the Chronic Care Model (CCM). American Diabetes Association. Strain WD, Holst AG, Rasmussen S, et al. Common ground on dietary approaches for the prevention, management, and potential remission of type 2 diabetes can be found, argue Nita G Forouhi and colleagues Dietary factors are of paramount importance in the management and prevention of type 2 diabetes. A detailed summary of the clinical trials data can be found in “11. 10.25 For patients who do not tolerate the intended intensity, the maximally tolerated statin dose should be used. Patients with older age, CKD, and frailty have been shown to be at higher risk of adverse effects of intensive blood pressure control. Such programs need to provide pathways for timely referral for a comprehensive eye examination when indicated. ��Qu��J���KX#�4j�����9�[�{�Ic�I�/�����Q��2������ \�UH�n�;��'� \�_
As many as 79 million adults in the U.S. have “pre-diabetes” and are at high risk of developing T2D. Found inside – Page 776Reduction in the incidence of type 2 diabetes with lifestyle intervention ... Nutrition therapy recommendations for the management of adults with diabetes. Unless there is a clear clinical diagnosis based on overt signs of hyperglycemia, diagnosis requires two abnormal test results from the same sample or in two separate test samples. This double-blind, double-dummy, phase 3, superiority study enrolled adults with a body-mass index of at least 27 kg/m 2 and glycated haemoglobin 7–10% (53–86 mmol/mol) who had been diagnosed with type 2 diabetes at least 180 days before screening. Methods: This randomized, double-blind, placebo-controlled trial included patients with type 2 diabetes and urine albumin-to-creatinine ratio 30 to 5000 mg/g and an estimated glomerular filtration rate ≥25 to <75 mL per min per 1.73 m 2, treated with optimized renin–angiotensin system blockade.Patients with a history of heart failure with reduced … Access to care and quality improvement, 1.5 Providers should assess social context, including potential food insecurity, housing stability, and financial barriers, and apply that information to treatment decisions. There is strong and consistent evidence that obesity management can delay the progression from prediabetes to type 2 diabetes (1–5) and is highly beneficial in the treatment of type 2 diabetes (6–17).In patients with type 2 diabetes who also have overweight or obesity, modest and sustained weight loss has been shown to improve glycemic control and … Type 2 diabetes: Goals for optimum management Encourage all people with type 2 diabetes to approach/reach these goals Diet Advise eating according to Australian dietary guidelines, with attention to quantity and type of food If concerns are held regarding cardiovascular disease (CVD) risk, advise individual dietary review Type 2 diabetes is the most common form of diabetes in Australia. Diabetes is a common, deadly, and expensive medical condition. A, 8.8 Food availability should be queried, as well as other cultural circumstances that could affect dietary patterns. CREDENCE, Evaluation of the Effects of Canagliflozin on Renal and Cardiovascular Outcomes in Participants With Diabetic Nephropathy. Be aware that, if metformin is contraindicated or not tolerated, repaglinide is both endstream
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“Diabetes is about energy in and energy out,” explains Dr. Chistofides. E, 6.14 Hypoglycemia unawareness or one or more episodes of level 3 hypoglycemia should trigger hypoglycemia avoidance education and reevaluation of the treatment regimen. The new IDF Clinical Practice Recommendations for managing Type 2 Diabetes in Primary Care seek to summarise current evidence around optimal management of people with type 2 diabetes. estimates of diabetes in this report do not differentiate between type 1 and type 2 diabetes. A An insulin regimen with basal, prandial, and correction components is the preferred treatment for noncritically ill hospitalized patients with good nutritional intake. B. In December 2020, we made minor changes to the recommendations on diabetic … This guideline covers the diagnosis and management of type 1 and type 2 diabetes in children and young people aged under 18. DeFronzo RA, Lewin A, Patel S, et al. Management of Diabetes in Pregnancy” in the complete 2020 Standards of Care provides details on the management of preexisting diabetes in pregnancy. C, 11.38 Provide general preventive foot self-care education to all patients with diabetes. The American College of Cardiology/American Heart Association ASCVD risk calculator (Risk Estimator Plus) is a useful tool to estimate 10-year ASCVD risk (http://tools.acc.org/ASCVD-Risk-Estimator-Plus). Found insideThis is an excellent resource for physicians seeking to provide the most current treatment for their patients. Therapy for Diabetes Mellitus and Related Disorders is the most comprehensive clinical reference work available on the disease. Glycemic Targets” in the complete 2020 Standards of Care for conditions causing discrepancies.) *The Canadian Diabetes Association is the registered owner of the name Diabetes Canada. B *Referring clinicians may wish to discuss with their nephrology service, depending on local arrangements regarding treating or referring. Found inside – Page 984Scientific Advances and Best Practice Joel Faintuch, Salomão Faintuch ... prevalence in OECD countries IDF-T2D-CPR-2017-print.pdf Type 2 diabetes guidelines ... These guidelines give up-to-date, evidence-based information tailored for general practice to support general practitioners (GPs) and their teams in providing high-quality management.|In developing the 2020 edition of Management of type 2 diabetes: A handbook for general practice, The Royal Australian College of General Practitioners (RACGP) has focused on factors relevant to current … Based on these studies, the American Diabetes … A, 8.10 To achieve weight loss of >5%, short-term (3-month) interventions that use very low-calorie diets (≤800 kcal/day) and meal replacements may be prescribed for carefully selected patients by trained practitioners in medical care settings with close medical monitoring. 15.10 There should be a structured discharge plan tailored to the individual patient with diabetes. guidelines as for functionally dependant but consideration around: Stop Sulfonylureas if Hba1c < 53 mmol/mol as increased risk of hypoglycaemia in this group Consider simplifying regimens as third party may need to administer. Introduction. A concern that statins or other lipid-lowering agents might cause cognitive dysfunction or dementia is not currently supported by evidence and should not deter their use in individuals with diabetes at high risk for ASCVD. 9.10 In patients with type 2 diabetes who need greater glucose lowering than can be obtained with oral agents, glucagon-like peptide 1 receptor agonists are preferred to insulin when possible. A. CKD is characterized by persistent albuminuria, low eGFR, and other manifestations of kidney damage (Figure 11.1). Reprinted with permission from Vassalotti JA, Centor R, Turner BJ, Greer RC, Choi M, Sequist TD; National Kidney Foundation Kidney Disease Outcomes Quality Initiative. Type 2 diabetes (T2D) mellitus has long been considered a disease affecting adults, but now about 24% of children diagnosed with diabetes have T2D [1]. Additionally, time below target (<70 and <54 mg/dL [3.9 and 3.0 mmol/L]) and time above target (>180 mg/dL [10.0 mmol/L]) are useful parameters for reevaluation of the treatment regimen. VA/DoD CLINICAL PRACTICE GUIDELINE FOR THE MANAGEMENT OF TYPE 2 DIABETES MELLITUS IN PRIMARY CARE . eGFR, estimated glomerular filtration rate; SGLT2, sodium–glucose cotransporter-2; T2D, type 2 diabetes. B, 10.36 Dual antiplatelet therapy (with low-dose aspirin and a P2Y12 inhibitor) is reasonable for a year after an acute coronary syndrome A and may have benefits beyond this period. Adapted from Davies MJ, D'Alessio DA, Fradkin J, et al. Diabetes and chronic kidney disease (CKD) commonly coexist and are associated with high risk for morbidity and mortality. Management of Type 2 Diabetes First produced: June 2009 Updated: July 2018 Review date: June 2020 (Extended to June 2021) Page 4 of 36 Treatment algorithm for type 2 diabetes in adults Adopt an individualised approach to diabetes care that is tailored to the needs and circumstances of adults with type 2 Mineralocorticoid receptor antagonists are effective for management of resistant hypertension in patients with type 2 diabetes when added to existing treatment with an ACE inhibitor or ARB, thiazide-like diuretic, or dihydropyridine CCB. Pharmacologic Approaches to Glycemic Treatment”, http://tools.acc.org/ASCVD-Risk-Estimator-Plus, “11. In 2020 the guidelines and associated consumer education materials were reviewed and updated. ADA’s grading system uses A, B, C, or E to show the evidence level that supports each recommendation. Quality standard - Diabetes in adults. Found inside – Page 1141As new developments in diabetes treatment evolve, ongoing education is necessary to ... Prevention ro delay of type 2 diabetes: Standards of Medical Care in ... C, 9.1 Most people with type 1 diabetes should be treated with MDI of prandial and basal insulin or CSII. How to Use ADA’s Type 2 Diabetes Treatment Algorithm Carlos Mendez, MD, FACP Presenter Disclosure Information In compliance with the accrediting board policies, the American Diabetes Association requires the following disclosure to the participants: Carlos Mendez, MD, … However, as type 2 diabetes accounts for 90% to 95% of all diabetes cases, the data presented here are more likely to be characteristic of type 2 diabetes… Makkar’s Diabetes and The complete 2020 Standards supplement, including all supporting references, is available at professional.diabetes.org/standards. The numbers in the boxes are a guide to the frequency of visits (number of times per year). Older adults are at higher risk of hypoglycemia for many reasons, including insulin deficiency necessitating insulin therapy and progressive renal insufficiency. Summary of glycemic recommendations for many nonpregnant adults with diabetes. A, 8.17 Metabolic surgery should be performed in high-volume centers with multidisciplinary teams knowledgeable about and experienced in the management of diabetes and gastrointestinal surgery. The CCM includes six core elements to optimize the care of patients with chronic disease: 1. Patients with diabetes should be encouraged to undergo recommended age- and sex-appropriate cancer screenings and to reduce their modifiable cancer risk factors (obesity, physical inactivity, and smoking). ii | Management of type 2 diabetes: A handbook for general practice Clinical management goals Treatment targets for people with type 2 diabetes include the following. 3. In the critical care setting, continuous intravenous insulin infusion is the best method for achieving glycemic targets. B, 10.42 In patients with type 2 diabetes with stable HF, metformin may be continued for glucose lowering if eGFR remains >30 mL/min but should be avoided in unstable or hospitalized patients with HF. For appropriate context, see Figure 4.1. The prevalence of diabetes in pregnancy is increasing in the U.S. along with the epidemic in obesity seen worldwide. Potential adverse effects of antihypertensive therapy (e.g., hypotension, syncope, falls, acute kidney injury, and electrolyte abnormalities) should also be taken into account. �@�_e�����!��� ! This guideline covers care and management for adults (aged 18 and over) with type 2 diabetes. INTRODUCTION. Those who are determined to be at high risk for type 2 diabetes, including people with an A1C of 5.7–6.4% (39–47 mmol/mol), impaired glucose tolerance, or impaired fasting glucose, are ideal candidates for diabetes prevention efforts. Adapted with permission from Inzucchi SE, Bergenstal RM, Buse JB, et al. 5.26 Adults with type 1 C and type 2 B diabetes should engage in 2–3 sessions/week of resistance exercise on nonconsecutive days. C, 11.2 Optimize glucose control to reduce the risk or slow the progression of CKD. The safety and efficacy of noninsulin glucose-lowering therapies in the hospital setting is an area of active research. Type 2 diabetes mellitus consists of an array of dysfunctions characterized by hyperglycemia and resulting from the combination of resistance to insulin action, inadequate insulin secretion, and excessive or inappropriate glucagon secretion. A 5-year effectiveness study of the CCM in 53,436 primary care patients with type 2 diabetes suggested that the use of this model of care delivery reduced the cumulative incidence of diabetes-related complications and all-cause mortality. Diabetes is a national health priority. et al. A, 6.16 Ongoing assessment of cognitive function is suggested with increased vigilance for hypoglycemia by the clinician, patient, and caregivers if low cognition or declining cognition is found. B, 14.4 Women with preexisting diabetes who are planning a pregnancy should ideally be managed beginning in preconception in a multidisciplinary clinic including an endocrinologist, maternal-fetal medicine specialist, dietitian, and diabetes educator, when available. It is now clear that the progressive … For national recommendations, references and additional copies of the guideline, go to www.healthteamworks.org or call (303) 446-7200. SMBG is an integral component of effective therapy for patients taking insulin. B, 14.24 Women with a history of GDM found to have prediabetes should receive intensive lifestyle interventions and/or metformin to prevent diabetes. B If one class is not tolerated, the other should be substituted. C. 5.25 Most adults with type 1 C and type 2 B diabetes should engage in 150 min or more of moderate- to vigorous-intensity aerobic activity per week, spread over at least 3 days/week, with no more than 2 consecutive days without activity. The recommendations, tables, and figures included here retain the same numbering used in the complete 2020 Standards and so are not numbered sequentially in this abridged version. CVOTs, CV outcomes trials; DPP-4i, dipeptidyl peptidase 4 inhibitor; GLP-1 RA, GLP-1 receptor agonist; SGLT2i, SGLT2 inhibitor; SU, sulfonylurea; TZD, thiazolidinedione. Particular attention should be paid to complications that would lead to functional impairment. B, 10.41 In patients with prior myocardial infarction, β-blockers should be continued for at least 2 years after the event. This population has unique challenges and requires distinct treatment considerations. BP, blood pressure. The Standards are developed by the ADA’s multidisciplinary Professional Practice Committee, which comprises physicians, diabetes educators, and other expert diabetes health care professionals. Diabetes mellitus (DM) is a chronic metabolic disorder characterized by persistent hyperglycemia. Readers may link to the version of record of this work on professional.diabetes.org/standards, but ADA permission is required to post this work on any third-party website or platform. Potential benefits must be weighed against potential risks of medications. DOI: 10.2337/dci19-0066. NICE Pathway on diabetes in pregnancy. B, 2.8 Testing for prediabetes and/or type 2 diabetes should be considered in women planning pregnancy with overweight or obesity and/or who have one or more additional risk factor for diabetes (Table 2.3). For patients with complications and reduced functionality, it is reasonable to set less intensive glycemic goals. • Metabolic surgery is a recommended treatment option for adults with type 2 diabetes and (1) a BMI of 40 or over (or 37.5 or over in people of Asian ancestry) or (2) a BMI of 35.0 to 39.9 (32.5–37.4 kg/m 2 … B, 11.15 Patients with type 2 diabetes should have an initial dilated and comprehensive eye examination by an ophthalmologist or optometrist at the time of the diabetes diagnosis. Found inside – Page 193Academy of Nutrition and Dietetics Nutrition Care Manual. Type 2 diabetes mellitus. https://www ... Standards of medical care in diabetes—2020. All of the recommendations included here are substantively the same as in the complete Standards. See “4. Many complications are associated with the disease, including an increased risk for cardiovascular disease. Diabetes Minimum Practice Recommendations for Children and Adolescents Revised: 10/27/16 (PDF, 81kb) Diabetes Minimum Practice Recommendations for Adults Revised: 10/27/16 (PDF, 82kb) Prevention. A, 8.16 Metabolic surgery may be considered as an option for adults with type 2 diabetes and BMI 30.0–34.9 kg/m2 (27.5–32.4 kg/m2 in Asian Americans) who do not achieve durable weight loss and improvement in comorbidities (including hyperglycemia) with tested efficacious nonsurgical methods. Figure 1| Recommendations and select practice points from the Kidney Disease: Improving Global Outcomes 2020 Clinical Practice Guideline for Diabetes Management in Chronic Kidney Disease (CKD). There is strong evidence that treating obesity can delay the progression from prediabetes to type 2 diabetes. Diabetes confers an increase maternal and fetal risk. E, 8.3 For patients with a high level of weight-related distress, special accommodations should be made to ensure privacy during weighing. DOI: 10.1161/CIR.0000000000000766 CLINICAL STATEMENTS AND GUIDELINES T he epidemic of type 2 diabetes mellitus (T2DM), linked to the increased burden of obesity, is pro-jected to affect >600 million patients worldwide in the next 2 decades.1 T2DM has a major impact on Found insideIntended for diabetes researchers and medical professionals who work closely with patients with diabetes, this newly updated and expanded edition provides new perspectives and direct insight into the causes and consequences of this serious ... Overtreatment of diabetes complications and reduced functionality, it is important for providers to realize that classification of diabetes such! A password for the aging population health ( SDoH ) be initiated for treatment of other CV risk factors diabetes... 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