Treatment of Type 2 Diabetes by Patient Profile in the Clinical Practice of Endocrinology in Spain : Delphi Study Results from the Think Twice Program
Morillas, C. (Hospital Universitari Doctor Peset (València))
Escalada, J. (Clínica Universidad de Navarra)
Palomares, R. (Hospital Universitario Reina Sofía (Còrdova, Espanya))
Bellido Guerrero, Diego (Hospital Arquitecto Marcide. Complejo Hospitalario Universitario de Ferrol [CHUF])
Gómez-Peralta, Fernando (Hospital General de Segovia)
Pérez Pérez, Antonio (Institut d'Investigació Biomèdica Sant Pau)
Universitat Autònoma de Barcelona

Data:	2019
Resum:	The aim of this Delphi study is to unveil the management of patients with type 2 diabetes (T2D) and different levels of complexity in the clinical practice in Spain. Based on the common management practices of T2D profiles reported by Spanish endocrinologists, a Delphi questionnaire of 55 statements was developed and responded to by a national panel (n = 101). A consensus was reached for 30 of the 55 statements. Regarding overweight patients inadequately controlled with metformin, treatment with a sodium-glucose transport protein 2 inhibitor (SGLT2-I) is preferred over treatment with a dipeptidyl peptidase-4 inhibitor (DPP4-I). If the patient is already being treated with a DPP4-I, an SGLT2-I is added on to the treatment regimen rather than replacing the DPP4-I. Conversely, if the treatment regimen includes a sulfonylurea, it is usually replaced by other antihyperglycemic agents. Current treatment trends in uncontrolled obese patients include the addition of an SGLT2-I or a glucagon-like peptide-1 receptor agonist (GLP1-RA) to background therapy. When the glycated hemoglobin target is not reached, triple therapy with metformin + GLP1-RA + SGLT2-I is initiated. Although SGLT2-Is are the treatment of choice in patients with T2D and heart failure or uncontrolled hypertension, no consensus was reached regarding the preferential use of SGLT2-Is or GLP1-RAs in patients with established cardiovascular disease. Consensus has been reached for a variety of statements regarding the management of several T2D profiles. Achieving a more homogeneous management of complex patients with T2D may require further evidence and a better understanding of the key drivers for treatment choice. Logistic support was provided by ESTEVE Pharmaceuticals S. A Spain.
Drets:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, sempre que no sigui amb finalitats comercials, i sempre que es reconegui l'autoria de l'obra original.
Llengua:	Anglès
Document:	Article ; recerca ; Versió publicada
Matèria:	Clinical practice ; Complex patient ; Delphi questionnaire ; Endocrinology ; Type 2 diabetes
Publicat a:	Diabetes Therapy, Vol. 10 Núm. 5 (january 2019) , p. 1893-1907, ISSN 1869-6961

DOI: 10.1007/s13300-019-0671-x
PMID: 31359366

15 p, 725.3 KB

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