Algorithm for the treatment of type 2 diabetes: a position statement of Brazilian Diabetes Society

Antonio C Lerario, Antonio R Chacra, Augusto Pimazoni-Netto, Domingos Malerbi, Jorge L Gross, José Ep Oliveira, Marilia B Gomes, Raul D Santos, Reine Mc Fonseca, Roberto Betti, Roberto Raduan, Antonio C Lerario, Antonio R Chacra, Augusto Pimazoni-Netto, Domingos Malerbi, Jorge L Gross, José Ep Oliveira, Marilia B Gomes, Raul D Santos, Reine Mc Fonseca, Roberto Betti, Roberto Raduan

Abstract

The Brazilian Diabetes Society is starting an innovative project of quantitative assessment of medical arguments of and implementing a new way of elaborating SBD Position Statements. The final aim of this particular project is to propose a new Brazilian algorithm for the treatment of type 2 diabetes, based on the opinions of endocrinologists surveyed from a poll conducted on the Brazilian Diabetes Society website regarding the latest algorithm proposed by American Diabetes Association /European Association for the Study of Diabetes, published in January 2009.An additional source used, as a basis for the new algorithm, was to assess the acceptability of controversial arguments published in international literature, through a panel of renowned Brazilian specialists. Thirty controversial arguments in diabetes have been selected with their respective references, where each argument was assessed and scored according to its acceptability level and personal conviction of each member of the evaluation panel.This methodology was adapted using a similar approach to the one adopted in the recent position statement by the American College of Cardiology on coronary revascularization, of which not only cardiologists took part, but also specialists of other related areas.

References

    1. Patel MR, Dehemer GJ, Hirshfeld JW, Smith PK, Spertus JA. ACCF/SCAI/STS/AATS/AHA/ASNC 2009 Appropriateness Criteria for Coronary Resvascularization. J Am Coll Cardiol. 2009;53(6):530–553. doi: 10.1016/j.jacc.2008.10.005.
    1. Gomes MB. Enquete sobre Algoritmo American Diabetes Association/European Association for the Study of Diabetes - December 2008 - 217 SBD Associates. Accessed on 07/13/09.
    1. Grupo Interdisciplinar de Padronização da Hemoglobina Glicada - A1C. Atualização sobre Hemoglobina Glicada (A1C) para Avaliação do Controle Glicêmico e para o Diagnóstico do Diabetes: Aspectos Clínicos e Laboratoriais. Posicionamento Oficial 3ª Edição. Brazilian Diabetes Society, Brazilian Endocrinology and Metabolim Society, Brazilian Clinical and Pathology Society, National Diabetes Federation. 2009.
    1. American Diabetes Association. Standards of Medical Care in Diabetes - 2009. Diabetes Care. 2010;32(Suppl 1):S16–S61.
    1. Pignone M. Decisions about intensity of glycemic control should depend on age and functional status. Clinical Diabetes. 2009;27:147–8. doi: 10.2337/diaclin.27.4.147.
    1. Joslin Diabetes Center & Joslin Clinic. Clinical Guideline for Pharmacological Management of Type 2 Diabetes, 2007. Accessed on 07/13/09.
    1. Joslin Diabetes Center & Joslin Clinic. Clinical guideline for adults with diabetes,2009. Accessed on 07/13/09.
    1. Blonde L, Einhorn D, Grunberger G, Handelsman Y, Hellsman Y, Hellman R, Lebovitz H, Levy P, Roberts VL. for the ACE/AACE Diabetes Road Map Task Force. Road Maps to Achieve Glycemic Control in Type 2 Diabetes Mellitus. Endocrine Practice. 2007;13(3):260–261. Accessed on 13/02/2010.
    1. Rodbard HW, Blonde L, Braithwaite SS, Brett EM, Cobin RH, Handelsman Y, Hellman R, Jellinger PS, Jovanovic LG, Levy P, Mechanick JI, Zangeneh F. AACE Diabetes Mellitus Clinical Practice Guidelines Task Force. American Association of Clinical Endocrinologists medical guidelines for clinical practice for the management of diabetes mellitus. Endocr Pract. 2007;13(Suppl1):1–68.
    1. Rodbard HW, Jellinger PS, Davidson JA, Einhorn D, Garber A, Grunberger G, Handelsman Y, Horton ES, Lebovitz H, Levy P, Moghissi ES, Schartz SS. Statement by an American Association of Clinical Endocrinologists/American College of Endocrinology Consensus Panel on type 2 diabetes mellitus:an algorithm for glycemic control. Endocrine Practice. 2009;15:540–559.
    1. Grant RW. How Doctors Choose Medications to Treat T2DM. Diabetes Care. 2007;30:1448–1453. doi: 10.2337/dc06-2499.
    1. Nathan DM, Buse JB, Davidson MB, Heine RJ, Holman RR, Sherwin R, Zinman B. Medical Management of Hyperglycemia in Type 2 Diabetes: A Consensus Algorithm for the Initiation and Adjustment of Therapy. Diabetes Care. 2009;32:193–20. doi: 10.2337/dc08-9025.
    1. Matveyenko AV, Dry S, Cox HI, Moshtahian A, Gurlo T, Galasso R, Butler AE, Butler PC. Beneficial endocrine but adverse exocrine effects of sitaglipitinin the HIP rat model of type 2 diabetes, interactions with metformin. Diabetes. 2008;58:1604–1615. doi: 10.2337/db09-0058.
    1. Nachani JS, Bulchadani DG, Nookala A, Herndon B, Molteni A, Pandya P, Taylor R, Weide L, Alba LM. Biochemical and histological effects of exendin-4(exenatide) on the rat pancreas. Diabetologia. 2010;53:153–159. doi: 10.1007/s00125-009-1515-4.
    1. McMahon GT, Dlhy RG. Intention to Treat -- Initiating Insulin and the 4-T Study. N Engl J Med. 2000;357(17):1759–61. doi: 10.1056/NEJMe078196. 17.
    1. Hemkens LG, Grouven U, Bender R, Günster C, Gutschmidt S, Selke GW Sawicki PT. Risk of malignancies in patients with diabetes treated with human insulin or insulin analogues: a cohort study. Diabetologia. 2009;52:1732–44. doi: 10.1007/s00125-009-1418-4.
    1. Deyo JP;, Ramsey RA. Evidence-Based Clinical Practice: Concepts and Approaches. Butterworth-Heinemann. Boston, USA; 2000.
    1. Lista de Preços de Medicamentos. Accessed on 03/20/2010.
    1. Lista de preços de medicamentos. Portal Elomédico. Accessed on 07/13/09.

Source: PubMed

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