DCRM Multispecialty Practice Recommendations for the management of diabetes, cardiorenal, and metabolic diseases.
DCRM Multispecialty Practice Recommendations for the management of diabetes, cardiorenal, and metabolic diseases.
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DOI：
10.1016/j.jdiacomp.2021.108101
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发表时间：
2022-02
影响因子：
3
通讯作者：
Weir, Matthew R.
中科院分区：
文献类型：
--
作者：
Handelsman, Yehuda;Anderson, John E.;Bakris, George L.;Ballantyne, Christie M.;Beckman, Joshua A.;Bhatt, Deepak L.;Bloomgarden, Zachary T.;Bozkurt, Biykem;Budoff, Matthew J.;Butler, Javed;Dagogo-Jack, Samuel;de Boer, Ian H.;DeFronzo, Ralph A.;Eckel, Robert H.;Einhorn, Daniel;Fonseca, Vivian A.;Green, Jennifer B.;Grunberger, George;Guerin, Chris;Inzucchi, Silvio E.;Jellinger, Paul S.;Kosiborod, Mikhail N.;Kushner, Pamela;Lepor, Norman;Mende, Christian W.;Michos, Erin D.;Plutzky, Jorge;Taub, Pam R.;Umpierrez, Guillermo E.;Vaduganathan, Muthiah;Weir, Matthew R.
关键词：
2 型糖尿病 (T2D)、慢性肾脏病 (CKD)、动脉粥样硬化性心血管疾病 (ASCVD) 和心力衰竭 (HF) 及其相关危险因素具有重叠的病因，并且同一患者经常会出现两种或多种这些疾病。最近的许多心血管结局试验 (CVOT) 已经证明了最初开发用于控制 T2D、ASCVD 或 CKD 危险因素的药物的益处，并且这些药物已经超越了其主要适应症，为一系列疾病带来益处。 CVOT 证据的这一演变需要不受单一学科限制的实践建议，以帮助临床医生管理患有糖尿病、心肾和/或代谢 (DCRM) 疾病等复杂疾病的患者。这些建议的最终目标是全面而简洁，并且易于非专家（无论是专家还是初级保健临床医生）遵循。为了满足这一需求，我们成立了一个由领先的心脏病专家、肾病专家、内分泌专家和初级保健医生组成的志愿者工作组，以制定 DCRM 实践建议，这是关于复杂代谢疾病患者综合管理的多专业共识。工作组的建议基于强有力的证据，并结合了临床相关且易于实施的实用指导，旨在改善 DCRM 患者的预后。这些建议以 18 个单独的图表形式呈现，涵盖生活方式治疗、患者自我管理教育、DCRM 管理技术、糖尿病前期、认知功能障碍、疫苗接种、临床测试、血脂、高血压、抗凝和抗血小板治疗、抗高血糖治疗、低血糖、非酒精性脂肪性肝病 (NAFLD) 和非酒精性脂肪性肝炎 (NASH)、ASCVD、HF、CKD 以及共病 HF 和 CKD，如以及用于 DCRM 的药物的图形摘要。
Type 2 diabetes (T2D), chronic kidney disease (CKD), atherosclerotic cardiovascular disease (ASCVD), and heart failure (HF)—along with their associated risk factors—have overlapping etiologies, and two or more of these conditions frequently occur in the same patient. Many recent cardiovascular outcome trials (CVOTs) have demonstrated the benefits of agents originally developed to control T2D, ASCVD, or CKD risk factors, and these agents have transcended their primary indications to confer benefits across a range of conditions. This evolution in CVOT evidence calls for practice recommendations that are not constrained by a single discipline to help clinicians manage patients with complex conditions involving diabetes, cardiorenal, and/or metabolic (DCRM) diseases. The ultimate goal for these recommendations is to be comprehensive yet succinct and easy to follow by the nonexpert—whether a specialist or a primary care clinician. To meet this need, we formed a volunteer task force comprising leading cardiologists, nephrologists, endocrinologists, and primary care physicians to develop the DCRM Practice Recommendations, a multispecialty consensus on the comprehensive management of the patient with complicated metabolic disease. The task force recommendations are based on strong evidence and incorporate practical guidance that is clinically relevant and simple to implement, with the aim of improving outcomes in patients with DCRM. The recommendations are presented as 18 separate graphics covering lifestyle therapy, patient self-management education, technology for DCRM management, prediabetes, cognitive dysfunction, vaccinations, clinical tests, lipids, hypertension, anticoagulation and antiplatelet therapy, antihyperglycemic therapy, hypoglycemia, nonalcoholic fatty liver disease (NAFLD) and nonalcoholic steatohepatitis (NASH), ASCVD, HF, CKD, and comorbid HF and CKD, as well as a graphical summary of medications used for DCRM.
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