| Effectiveness/Harms of Early Treatment | |
- Recognize that although tight glycemic control in persons clinically diagnosed with type 2 diabetes may reduce intermediate markers of diabetes complications, it has not been convincingly shown to lead to significant reductions in end-organ complications or mortality rates.
 - Note that metformin treatment in overweight patients with newly diagnosed diabetes is associated with reductions in mortality rates, MI, and diabetes complications.
- Appreciate that tight BP control in patients with diabetes is associated with reductions in cardiovascular outcomes and deaths and that optimal BP targets differ depending on diabetes status.
- Know that treatment of type 2 diabetes patients with microalbuminuria and overt nephropathy using ACE inhibitors and angiotensin-receptor blocking agents reduces the risk of nephropathy progression.
- Note that it remains unclear whether hypertensive patients with diabetes without nephropathy should be treated with different antihypertensive agents than those without diabetes.
- Recognize that patients with diabetes derive substantial benefit through primary and secondary prevention of cardiovascular events and death with lipid-lowering treatment, even with near-normal baseline lipid levels.
- Note that patients with diabetes have similar relative benefits on CVD protection with ASA treatment as those without diabetes, but their absolute benefit may be greater due to their greater baseline risk of CVD.
- Recognize that there is no evidence that initiation of foot care programs during the preclinical phase of diabetes provides additional benefit.
 - Know that there is limited evidence regarding the harms of early treatment in patients with diabetes diagnosed through screening, but the recommended treatments have been shown to be safe in those diagnosed clinically.
|  | | FAQs |
|
|
Denice S. Feig, MD, MSc, FRCPC has no financial relationships with pharmaceutical companies, biomedical device manufacturers, or health-care related organizations. Lorraine Lipscombe, MD, FRCPC has no financial relationships with pharmaceutical companies, biomedical device manufacturers, or health-care related organizations. Sonal Singh, MD, editorial consultant, has no financial relationships with pharmaceutical companies, biomedical device manufacturers, or health-care related organizations.
Deborah Korenstein, MD, FACP, Co-Editor, PIER, has no financial relationships with pharmaceutical companies, biomedical device manufacturers, or health-care related organizations. Richard B. Lynn, MD, FACP, Co-Editor, PIER, has no financial relationships with pharmaceutical companies, biomedical device manufacturers, or health-care related organizations. |
|
|
|
The information included herein should never be used as a substitute
for clinical judgment and does not represent an official position of
ACP. Because all PIER modules are updated regularly, printed web pages
or PDFs may rapidly become obsolete. Therefore, PIER users should
compare the date of the last update on the website with any printout
to ensure that the information being referred to is the most current
available.
|
PIER is copyrighted © 2012 by the American College of Physicians,
190 N. Independence Mall West, Philadelphia, PA 19106-1572, USA.
|
|
Screening for Type 2 Diabetes
