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A1c >8%

8.5

NHANES/BRFSS; Harmel, et al.

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~ 30% 2 7.5

A1c <8%
7.0
Harmel et al.
6.5
6.0

<7
< 6.5
6

ADA

AACE/ACE

5.5
ADA. Diabetes Care 2003; 26(Suppl 1): S33-S50
ACE. Consensus Conference on Guidelines for Glycemic Control. Endocrine Practice 2002
NCQA. Health Plan Employer Data and Information Set (HEDIS) 2000
NCQA. State of Managed Care Quality 2000

P<0.001

P<0.001

P<0.001

7%
140mmHg
150mg/dl

100mg/dl

40/50mg/dl

LIATIS ET AL ,2013

Steno 2 study:

IGT

(Uncontrolle
d)

(mg/dl)

126

100

()

20

10

10

20

30

Adapted from Bergenstal RM, et al. Diabetes mellitus, carbohydrate metabolism and lipid disorders. In
Endocrinology. 4th ed. 2001.

Diabetes Care 2015;38(Suppl. 1):S41S48


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DiabetesCare,Diabetologia.19April2012

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DiabetesCare,Diabetologia.19April2012

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MICHAEL N. COOK DIABETES CARE, VOLUME 28, NUMBER


5, MAY 2005


HbA1c
10
27b
8,8

HbA1c, %

35b
9,1


(n=513 )

(n=3.394 )

7,7
7,1
ADA

IDF

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HbA1c

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, 19942002, b .
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Brown JB et al. Diabetes Care. 2004;27(7):15351540; American Diabetes Association. Diabetes Care. 2010;33(suppl 1):S11S61;
International Diabetes Federation. www.idf.org/webdata/docs/Guideline_PMG.pdf. Accessed September 2, 2010.
a

. Aloumanis et al Primary care Diabetes 2013

Conventional*
Glibenclamide
Metformin
Insulin

HbA1c (%)

8.5
8
7.5
7

Recommended treatment
target <7.0%

6.5
6

6.2% upper limit of normal range


0

Years from randomisation


*Diet initially then sulphonylureas, insulin and/or metformin if FPG>15 mmol/L
ADA clinical practice recommendations. UKPDS 34, n=1704

UKPDS 34. Lancet 1998:352:85465; Kahn et al. NEJM 2006;355(23):242743

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2011 by American College of Physicians

BennettWL,etal.AnnInternMed2011;154:602

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Leiter et al.

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Leiter et al.
2

1. Data on file. Market Research Novo Nordisk Nov. 2010 2. Leiter, et al. Can J Diabetes 2005;29(3):186-92


:
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< 60 ml/min per 1.73 m(2),
,
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HbA1c
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DavisClin Endocrinol Metab. 2010


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15 15

15 grams
3 4 tablets
4,5 dL
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kits

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Range of weight change (kg) in response


to diabetes medications1,2
Sulphonylureas
Glinides
Thiazolidinediones
Insulin
DPP-4 inhibitor (sitagliptin)
Metformin
GLP-1 receptor agonist (exenatide)
Dapagliflozin
6

10

Range of weight change (kg)

1. Mitri J, Hamdy O. Expert Opin Drug Saf 2009;8:57384; 2. Clar C, et al. BMJ 2012;2:e00107.
1055HQ13NP05636-01

Median 95% confidence interval

Biphasic
prandial

Prandial
basal

Basal
prandial

During the Diabetes Control and Complications Trial, insulin-treated patients


with severe hypoglycaemia had a significantly (P<0.05) greater increase in
weight than those without severe hypoglycaemia

Patients with severe


hypoglycaemia

+6.8 kg

Patients without severe


hypoglycaemia

+4.6 kg

Weight gain (kg)

A potential explanation for this is defensive snacking an increase in


a patients carbohydrate intake following hypoglycaemia due to their fear of
further events
Russell-Jones D, Khan R. Diabetes Obes Metab 2007;9:799812.
1055HQ13NP05636-01

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