Page 47 - The SA Journal Diabetes & Vascular Disease Volume 9 No 4 (November 2012)

VOLUME 9 NUMBER 4 • NOVEMBER 2012 189
SA JOURNAL OF DIABETES & VASCULAR DISEASE REPORT
People with diabetes to get individualised therapy in new EASD/ADA guidelines..........................................189
South African expert comments on the new EASD/ADA guideline................................................................190
New analysis shows liraglutide is more effective when used early in the management of type 2 diabetes.....190
Linagliptin is effective and well tolerated for patients with type 2 diabetes with different background
therapies....................................................................................................................................................190
Tighter regulation of medical devices in diabetes care...................................................................................191
Increased leisure-time physical activity reduces cardiovascular risk after diagnosis of type 2 diabetes............191
Most type 2 diabetes patients experience hypoglycaemia.............................................................................192
Insulin degludec shows 43% lower rates of night-time hypoglycaemia than insulin glargine........................192
Cholesterol target not achieved in most people with diabetes....................................................................192
2012 UPDATE FROM BERLIN, GERMANY
European Association for the Study of Diabetes 1–5 October 2012
Contributors: J Aalbers, Dr L Distiller
SUMMARIES
EASD WATCH
People with diabetes to get indi-
vidualised therapy in new EASD/
ADA guidelines
The European Association for the Study of
Diabetes (EASD) and the American Diabe-
tes Association (ADA) have published new
guidelines on the treatment of type 2 dia-
betes. For the first time, these guidelines
put the patient at the heart of the clinical
decision-making process.
The new position statement is less pre-
scriptive than previous guidelines, advo-
cates more patient involvement, and gives
guidance on the rational approach to the
choice of therapy. This choice will now
combine the best available evidence from
the literature with the clinician’s expertise
and the patient’s own inclinations.
Patient-centred care is defined as ‘an
approach to providing care that is respective
and responsive to individual patient pref-
erences, needs and values, ensuring that
the patients’ own values guide all clinical
decisions’. The EASD and ADA emphasise
that this should be the organising principal
underlying healthcare for individuals with
diabetes (and any chronic disease).
‘ Given the uncertainties in terms of type
and sequence of therapies, this approach is
particularly appropriate in type 2 diabetes’,
says EASD president Prof Andrew Boulton
( University of Manchester, UK). Ultimately,
it is the patients who make the final deci-
sions on their lifestyle choices and, to some
degree, the pharmacological interventions
they use. Implementation of therapy occurs
in the context of the patients’ real lives and
relies on the consumption of resources.
The new recommendations of the EASD
and ADA are asking not only for individu-
alised interventions in type 2 diabetes but
also discuss individualised goals. While
general recommendations regarding the
intensiveness of glycaemic therapy focused
in the past on an HbA1c target below 7%,
this new statement emphasises the prag-
Fig. 1 Depiction of the elements of decision making used to determine appropriate efforts to achieve
glycaemic targets. (Adapted from reference 1.)
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