Your browser doesn't support javascript.
Benefits and harms of intensive glycemic control in patients with type 2 diabetes.
BMJ ; 367: l5887, 2019 11 05.
Artículo en Inglés | MEDLINE | ID: mdl-31690574
Diabetes is a major and costly health concern worldwide, with high morbidity, disability, mortality, and impaired quality of life. The vast majority of people living with diabetes have type 2 diabetes. Historically, the main strategy to reduce complications of type 2 diabetes has been intensive glycemic control. However, the body of evidence shows no meaningful benefit of intensive (compared with moderate) glycemic control for microvascular and macrovascular outcomes important to patients, with the exception of reduced rates of non-fatal myocardial infarction. Intensive glycemic control does, however, increase the risk of severe hypoglycemia and incurs additional burden by way of polypharmacy, side effects, and cost. Additionally, data from cardiovascular outcomes trials showed that cardiovascular, kidney, and mortality outcomes may be improved with use of specific classes of glucose lowering drugs largely independently of their glycemic effects. Therefore, delivering evidence based, patient centered care to people with type 2 diabetes requires a paradigm shift and departure from the predominantly glucocentric view of diabetes management. Instead of prioritizing intensive glycemic control, the focus needs to be on ensuring access to adequate diabetes care, aligning glycemic targets to patients' goals and situations, minimizing short term and long term complications, reducing the burden of treatment, and improving quality of life.





Texto completo: Disponible Colección: Bases de datos internacionales Base de datos: MEDLINE Asunto principal: Calidad de Vida / Complicaciones de la Diabetes / Diabetes Mellitus Tipo 2 / Hipoglucemia / Hipoglucemiantes Tipo de estudio: Guía de práctica clínica Aspecto clínico: Etiología / Pronóstico / Terapia Límite: Humanos Idioma: Inglés Revista: BMJ Asunto de la revista: Medicina Año: 2019 Tipo del documento: Artículo País de afiliación: México