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Insulin Matters: A Practical Approach to Basal Insulin Management in Type 2 Diabetes

It is currently estimated that 11 million Canadians are living with diabetes or prediabetes. Although hyperglycemia is associated with serious complications, it is well established that improved glycemic control reduces the risk of microvascular complications and can also reduce cardiovascular (CV)...

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Autores principales: Berard, Lori, Antonishyn, Noreen, Arcudi, Kathryn, Blunden, Sarah, Cheng, Alice, Goldenberg, Ronald, Harris, Stewart, Jones, Shelley, Mehan, Upender, Morrell, James, Roscoe, Robert, Siemens, Rick, Vallis, Michael, Yale, Jean-François
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Healthcare 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6104258/
https://www.ncbi.nlm.nih.gov/pubmed/29476414
http://dx.doi.org/10.1007/s13300-018-0375-7
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author Berard, Lori
Antonishyn, Noreen
Arcudi, Kathryn
Blunden, Sarah
Cheng, Alice
Goldenberg, Ronald
Harris, Stewart
Jones, Shelley
Mehan, Upender
Morrell, James
Roscoe, Robert
Siemens, Rick
Vallis, Michael
Yale, Jean-François
author_facet Berard, Lori
Antonishyn, Noreen
Arcudi, Kathryn
Blunden, Sarah
Cheng, Alice
Goldenberg, Ronald
Harris, Stewart
Jones, Shelley
Mehan, Upender
Morrell, James
Roscoe, Robert
Siemens, Rick
Vallis, Michael
Yale, Jean-François
author_sort Berard, Lori
collection PubMed
description It is currently estimated that 11 million Canadians are living with diabetes or prediabetes. Although hyperglycemia is associated with serious complications, it is well established that improved glycemic control reduces the risk of microvascular complications and can also reduce cardiovascular (CV) complications over the long term. The UKPDS and ADVANCE landmark trials have resulted in diabetes guidelines recommending an A1C target of ≤ 7.0% for most patients or a target of ≤ 6.5% to further reduce the risk of nephropathy and retinopathy in those with type 2 diabetes (T2D), if it can be achieved safely. However, half of the people with T2D in Canada are not achieving these glycemic targets, despite advances in diabetes pharmacological management. There are many contributing factors to account for this poor outcome; however, one of the major factors is the delay in treatment advancement, particularly a resistance to insulin initiation and intensification. To simplify the process of initiating and titrating insulin in T2D patients, a group of Canadian experts reviewed the evidence and best clinical practices with the goal of providing guidance and practical recommendations to the diabetes healthcare community at large. This expert panel included general practitioners (GPs), nurses, nurse practitioners, endocrinologists, dieticians, pharmacists, and a psychologist. This article summarizes the panel recommendations.
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spelling pubmed-61042582018-08-27 Insulin Matters: A Practical Approach to Basal Insulin Management in Type 2 Diabetes Berard, Lori Antonishyn, Noreen Arcudi, Kathryn Blunden, Sarah Cheng, Alice Goldenberg, Ronald Harris, Stewart Jones, Shelley Mehan, Upender Morrell, James Roscoe, Robert Siemens, Rick Vallis, Michael Yale, Jean-François Diabetes Ther Practical Approach It is currently estimated that 11 million Canadians are living with diabetes or prediabetes. Although hyperglycemia is associated with serious complications, it is well established that improved glycemic control reduces the risk of microvascular complications and can also reduce cardiovascular (CV) complications over the long term. The UKPDS and ADVANCE landmark trials have resulted in diabetes guidelines recommending an A1C target of ≤ 7.0% for most patients or a target of ≤ 6.5% to further reduce the risk of nephropathy and retinopathy in those with type 2 diabetes (T2D), if it can be achieved safely. However, half of the people with T2D in Canada are not achieving these glycemic targets, despite advances in diabetes pharmacological management. There are many contributing factors to account for this poor outcome; however, one of the major factors is the delay in treatment advancement, particularly a resistance to insulin initiation and intensification. To simplify the process of initiating and titrating insulin in T2D patients, a group of Canadian experts reviewed the evidence and best clinical practices with the goal of providing guidance and practical recommendations to the diabetes healthcare community at large. This expert panel included general practitioners (GPs), nurses, nurse practitioners, endocrinologists, dieticians, pharmacists, and a psychologist. This article summarizes the panel recommendations. Springer Healthcare 2018-02-23 2018-04 /pmc/articles/PMC6104258/ /pubmed/29476414 http://dx.doi.org/10.1007/s13300-018-0375-7 Text en © The Author(s) 2018 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (https://creativecommons.org/licenses/by/4.0), which permits use, duplication, adaptation, distribution, and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.
spellingShingle Practical Approach
Berard, Lori
Antonishyn, Noreen
Arcudi, Kathryn
Blunden, Sarah
Cheng, Alice
Goldenberg, Ronald
Harris, Stewart
Jones, Shelley
Mehan, Upender
Morrell, James
Roscoe, Robert
Siemens, Rick
Vallis, Michael
Yale, Jean-François
Insulin Matters: A Practical Approach to Basal Insulin Management in Type 2 Diabetes
title Insulin Matters: A Practical Approach to Basal Insulin Management in Type 2 Diabetes
title_full Insulin Matters: A Practical Approach to Basal Insulin Management in Type 2 Diabetes
title_fullStr Insulin Matters: A Practical Approach to Basal Insulin Management in Type 2 Diabetes
title_full_unstemmed Insulin Matters: A Practical Approach to Basal Insulin Management in Type 2 Diabetes
title_short Insulin Matters: A Practical Approach to Basal Insulin Management in Type 2 Diabetes
title_sort insulin matters: a practical approach to basal insulin management in type 2 diabetes
topic Practical Approach
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6104258/
https://www.ncbi.nlm.nih.gov/pubmed/29476414
http://dx.doi.org/10.1007/s13300-018-0375-7
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