PMID- 30827909 OWN - NLM STAT- MEDLINE DCOM- 20200417 LR - 20221207 IS - 2530-0180 (Electronic) IS - 2530-0180 (Linking) VI - 66 IP - 7 DP - 2019 Aug-Sep TI - Document on a comprehensive approach to type 2 diabetes mellitus. PG - 443-458 LID - S2530-0164(19)30022-9 [pii] LID - 10.1016/j.endinu.2018.10.010 [doi] AB - OBJECTIVE: Treatment of type 2 diabetes mellitus (T2DM) is complex and is intended to decrease morbidity and mortality. Management should therefore include adequate diabetes education, lifestyle changes, drug treatment to achieve early blood glucose control and reduction of cardiovascular (CV) risk factors, early detection and treatment of complications, and assessment of associated comorbidities. The objective was to prepare a document including all aspects required for a comprehensive approach to T2DM. PARTICIPANTS: Members of the Diabetes Mellitus Working Group of the Spanish Society of Endocrinology. METHODS: The available evidence regarding each aspect of diabetes management (blood glucose control goals, diet and exercise, drug treatment, risk factor management and control, detection of complications, and management of frail patients) was reviewed. Recommendations were formulated based on the grades of evidence stated in the 2018 Standards of Medical Care in Diabetes. Recommendations were discussed and agreed by the working group members. CONCLUSIONS: This document is intended to provide evidence-based practical recommendations for comprehensive management of T2DM by clinical endocrinologists. CI - Copyright (c) 2019 SEEN y SED. Publicado por Elsevier Espana, S.L.U. All rights reserved. FAU - Reyes-Garcia, Rebeca AU - Reyes-Garcia R AD - Unidad de Endocrinologia y Nutricion, Hospital Universitario Torrecardenas, Servicio de Endocrinologia, Clinica San Pedro, Almeria, Espana; Servicio de Endocrinologia, Clinica San Pedro, Almeria, Espana. Electronic address: rebeca.reyes.garcia@gmail.com. FAU - Moreno-Perez, Oscar AU - Moreno-Perez O AD - Seccion de Endocrinologia y Nutricion, Hospital General Universitario de Alicante, Universidad Miguel Hernandez, Instituto de Investigacion Sanitaria y Biomedica de Alicante (ISABIAL-FISABIO), Alicante, Espana. FAU - Tejera-Perez, Cristina AU - Tejera-Perez C AD - Servicio de Endocrinologia y Nutricion, Complejo Hospitalario Universitario de Ferrol, Ferrol, La Coruna, Espana. FAU - Fernandez-Garcia, Diego AU - Fernandez-Garcia D AD - Unidad de Gestion Clinica de Endocrinologia y Nutricion, Hospital Universitario Virgen de la Victoria, Malaga, Espana; Servicio Endocrinologia y Nutricion, Hospital Vithas-Xanit, Benalmadena, Malaga, Espana. FAU - Bellido-Castaneda, Virginia AU - Bellido-Castaneda V AD - Servicio de Endocrinologia y Nutricion, Hospital Universitario Cruces, Baracaldo, Vizcaya, Espana. FAU - de la Torre Casares, Martin Lopez AU - de la Torre Casares ML AD - Servicio de Endocrinologia y Nutricion, Hospital Universitario Virgen de las Nieves, Granada, Espana. FAU - Rozas-Moreno, Pedro AU - Rozas-Moreno P AD - Servicio de Endocrinologia y Nutricion. Hospital General Universitario de Ciudad Real, Ciudad Real, Espana. FAU - Fernandez-Garcia, Jose Carlos AU - Fernandez-Garcia JC AD - Unidad de Gestion Clinica de Endocrinologia y Nutricion, Instituto de Investigacion Biomedica de Malaga (IBIMA), Hospital Universitario Virgen de la Victoria, Malaga, Espana; CIBER Fisiopatologia de la Obesidad y Nutricion (CIBERobn), CB06/03, Instituto de Salud Carlos III, Madrid, Espana. FAU - Marco Martinez, Amparo AU - Marco Martinez A AD - Endocrinologia y Nutricion, Complejo Hospitalario de Toledo, Toledo, Espana; Hospital Quiron Salud Madrid, Madrid, Espana. FAU - Escalada-San Martin, Javier AU - Escalada-San Martin J AD - Departamento de Endocrinologia y Nutricion, Clinica Universidad de Navarra; CIBER Fisiopatologia de la Obesidad y Nutricion (CIBEROBN), Instituto de Salud Carlos III, Madrid, Espana; Grupo de Diabetes y Enfermedades Metabolicas, Instituto de Investigacion Sanitaria de Navarra (IdiSNA), Pamplona, Espana. FAU - Gargallo-Fernandez, Manuel AU - Gargallo-Fernandez M AD - Seccion de Endocrinologia y Nutricion, Hospital Universitario Infanta Leonor, Madrid, Espana. FAU - Botana-Lopez, Manuel AU - Botana-Lopez M AD - Seccion de Endocrinologia y Nutricion, Hospital Universitario Lucus Augusti, Lugo, Espana. FAU - Lopez-Fernandez, Judith AU - Lopez-Fernandez J AD - Servicio de Endocrinologia y Nutricion, Hospital Universitario de Canarias, Departamento de Medicina, Universidad de La Laguna, Santa Cruz de Tenerife, Espana. FAU - Gonzalez-Clemente, Jose Miguel AU - Gonzalez-Clemente JM AD - Servicio de Endocrinologia y Nutricion, Hospital Parc Tauli, Instituto I3PT-UAB, DIAMET, CIBERDEM-ISCIII, Sabadell, Barcelona, Espana. FAU - Jodar-Gimeno, Esteban AU - Jodar-Gimeno E AD - Hospitales Universitarios Quiron Salud, Ruber Juan Bravo y San Jose, Facultad de Ciencias de la Salud, Universidad Europea de Madrid, Madrid, Espana. FAU - Mezquita-Raya, Pedro AU - Mezquita-Raya P AD - Unidad de Endocrinologia y Nutricion, Hospital Universitario Torrecardenas, Servicio de Endocrinologia, Clinica San Pedro, Almeria, Espana. CN - en representacion del Grupo de trabajo de Diabetes-SEEN LA - eng LA - spa PT - Journal Article PT - Practice Guideline TT - Documento de abordaje integral de la diabetes tipo 2. DEP - 20190228 PL - Spain TA - Endocrinol Diabetes Nutr (Engl Ed) JT - Endocrinologia, diabetes y nutricion JID - 101717565 RN - 0 (Glycated Hemoglobin A) RN - 0 (Hypoglycemic Agents) RN - 0 (Insulin) SB - IM MH - Algorithms MH - Cardiovascular Diseases/epidemiology/etiology/prevention & control MH - Clinical Trials as Topic MH - Combined Modality Therapy MH - Comorbidity MH - Cost-Benefit Analysis MH - Diabetes Complications/prevention & control MH - Diabetes Mellitus, Type 2/*therapy MH - Diet, Diabetic MH - Disease Management MH - Dyslipidemias/epidemiology/therapy MH - Evidence-Based Medicine MH - Exercise MH - Glycated Hemoglobin/analysis MH - Humans MH - Hypertension/epidemiology/therapy MH - Hypoglycemic Agents/economics/therapeutic use MH - Insulin/administration & dosage/therapeutic use MH - Life Style MH - Non-alcoholic Fatty Liver Disease/diagnosis/epidemiology MH - Patient Education as Topic MH - Sleep Apnea Syndromes/epidemiology OTO - NOTNLM OT - Abordaje integral OT - Comprehensive management OT - Diabetes tipo 2 OT - Drug treatment OT - Lifestyle changes OT - Modificaciones de estilo de vida OT - Tratamiento farmacologico OT - Type 2 diabetes mellitus EDAT- 2019/03/05 06:00 MHDA- 2020/04/18 06:00 CRDT- 2019/03/05 06:00 PHST- 2018/07/18 00:00 [received] PHST- 2018/10/21 00:00 [revised] PHST- 2018/10/31 00:00 [accepted] PHST- 2019/03/05 06:00 [pubmed] PHST- 2020/04/18 06:00 [medline] PHST- 2019/03/05 06:00 [entrez] AID - S2530-0164(19)30022-9 [pii] AID - 10.1016/j.endinu.2018.10.010 [doi] PST - ppublish SO - Endocrinol Diabetes Nutr (Engl Ed). 2019 Aug-Sep;66(7):443-458. doi: 10.1016/j.endinu.2018.10.010. Epub 2019 Feb 28.