Plataforma INVEST Medicina UANL-KER Unit Mayo Clinic (KER Unit México), Universidad Autónoma de Nuevo León, Monterrey, Mexico.
Endocrinology Division, Department of Internal Medicine, University Hospital "Dr. José E. González", Universidad Autónoma de Nuevo León, Francisco I. Madero y Av. Gonzalitos s/n, Mitras Centro, Monterrey, 64460, México.
Curr Diab Rep. 2021 Dec 13;21(12):63. doi: 10.1007/s11892-021-01433-0.
Present the value of a person-centered approach in diabetes management and review current evidence supporting its practice.
Early evidence from glycemic control trials in diabetes resulted in most practice guidelines adopting a glucose-centric intensive approach for management of the disease, consistently relying on HbA1c as a marker of metabolic control and success. This paradigm has been recently dispelled by new evidence that shows that intensive glycemic control does not provide a significant benefit regarding patient-important microvascular and macrovascular hard outcomes when compared to moderate glycemic targets. The goals of diabetes therapy are to reduce the risks of acute and chronic complications and increase quality of life while incurring least burden of treatment and disruption to the patient's life. A person-centered approach to diabetes management is achieved through shared decision making, integration of evidence-based care and patient´s needs, values and preferences, and minimally disruptive approaches to diabetes care and at the same time offer practical guidance to clinicians and patients on achieving this type of care.
介绍以人为本的方法在糖尿病管理中的价值,并回顾支持其应用的现有证据。
糖尿病患者的血糖控制试验早期证据导致大多数实践指南采用以血糖为中心的强化方法来管理该疾病,一直依赖 HbA1c 作为代谢控制和成功的标志物。这一模式最近被新证据所颠覆,该证据表明,与中等血糖目标相比,强化血糖控制并不能显著改善患者重要的微血管和大血管硬终点。糖尿病治疗的目标是降低急性和慢性并发症的风险,提高生活质量,同时将治疗负担和对患者生活的干扰降到最低。通过共同决策、整合基于证据的护理和患者的需求、价值观和偏好,以及对糖尿病护理的最小干扰方法,实现以人为本的糖尿病管理方法,同时为临床医生和患者提供实现这种护理类型的实用指导。