A Year of Small Steps
Changes in diabetes never happen as quickly as I would like, and for our patients, progress seems even slower. When I look back over the past year, I see that we have taken mostly small steps toward helping people live longer and healthier lives with diabetes. The topics discussed below seem to have had the most impact, however, on both my practice of medicine and my understanding of what might be available in the future.
New Cholesterol Guidelines
Updated cholesterol guidelines[1] from the American College of Cardiology and the American Heart Association have sparked controversy and spirited discussion about the overall management approach as well as a new online risk calculator, but few of the controversies apply to patients with diabetes.
The most significant changes for us involve stopping 2 established practices: using specific targets for patients' levels of low-density lipoprotein (LDL) cholesterol, and prescribing additional nonstatin drugs to address cardiovascular risk. But the guidelines are clear: If patients are at high risk, they need to be on statin therapy regardless of their LDL cholesterollevels. That includes all patients with diabetes between the ages of 40 and 75 years; depending on their 10-year risk for a cardiovascular event, they should be put on either a moderate-intensity or a high-intensity statin regimen.
Medscape Diabetes © 2013 WebMD, LLC
Cite this: Anne Peters: The Year in Diabetes - Medscape - Dec 10, 2013.
Type 2 Diabetes Mellitus
Type 2 Diabetes Mellitus Clinical Practice Guidelines (SID/AMD, 2022)
Pediatric Type 2 Diabetes Mellitus
COMMENTARY
Anne Peters: The Year in Diabetes
Anne L. Peters, MD; Mark Harmel, MPH
DisclosuresDecember 10, 2013
A Year of Small Steps
Changes in diabetes never happen as quickly as I would like, and for our patients, progress seems even slower. When I look back over the past year, I see that we have taken mostly small steps toward helping people live longer and healthier lives with diabetes. The topics discussed below seem to have had the most impact, however, on both my practice of medicine and my understanding of what might be available in the future.
New Cholesterol Guidelines
Updated cholesterol guidelines[1] from the American College of Cardiology and the American Heart Association have sparked controversy and spirited discussion about the overall management approach as well as a new online risk calculator, but few of the controversies apply to patients with diabetes.
The most significant changes for us involve stopping 2 established practices: using specific targets for patients' levels of low-density lipoprotein (LDL) cholesterol, and prescribing additional nonstatin drugs to address cardiovascular risk. But the guidelines are clear: If patients are at high risk, they need to be on statin therapy regardless of their LDL cholesterollevels. That includes all patients with diabetes between the ages of 40 and 75 years; depending on their 10-year risk for a cardiovascular event, they should be put on either a moderate-intensity or a high-intensity statin regimen.
Medscape Diabetes © 2013 WebMD, LLC
Cite this: Anne Peters: The Year in Diabetes - Medscape - Dec 10, 2013.
Tables
References
Authors and Disclosures
Authors and Disclosures
Author
Anne L. Peters, MD
Professor of Clinical Medicine; Director, Clinical Diabetes Programs, Keck School of Medicine, University of Southern California, Los Angeles, California
Disclosure: Anne L. Peters, MD, has disclosed the following financial relationships:
Served as director, officer, partner, employee, advisor, consultant, or trustee for: (current consultant): Amylin Pharmaceuticals, Inc.; Eli Lilly and Company; Novo Nordisk
Served as a speaker or member of a speakers bureau for: (current speakers bureau member): Amylin Pharmaceuticals, Inc.; Eli Lilly and Company; Novo Nordisk; Takeda Pharmaceuticals North America, Inc.
Served as a consultant or ad hoc speaker/consultant for: AstraZeneca Pharmaceuticals LP; Abbott Laboratories; Boehringer Ingelheim Pharmaceuticals, Inc.; Bristol-Myers Squibb Company; Dexcom; Medtronic MiniMed, Inc.; Merck & Co., Inc.; Roche; sanofi-aventis
Mark Harmel, MPH
Freelance writer and videographer, Los Angeles, California
Disclosure: Mark Harmel, MPH, has disclosed no relevant financial relationships.