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Practical steps to improving the management of type 1 diabetes: recommendations from the Global Partnership for Effective Diabetes Management

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TLDR
The Global Partnership for Effective Diabetes Management as mentioned in this paper provides practical recommendations to help improve the care of patients with type 1 diabetes, including reaching glycaemic goals, overcoming the reality and fear of hypoglycaemia, and appropriate insulin therapy and dose adjustment.
Abstract
The Diabetes Control and Complications Trial (DCCT) led to considerable improvements in the management of type 1 diabetes, with the wider adoption of intensive insulin therapy to reduce the risk of complications. However, a large gap between evidence and practice remains, as recently shown by the Pittsburgh Epidemiology of Diabetes Complications (EDC) study, in which 30-year rates of microvascular complications in the 'real world' EDC patients were twice that of DCCT patients who received intensive insulin therapy. This gap may be attributed to the many challenges that patients and practitioners face in the day-to-day management of the disease. These barriers include reaching glycaemic goals, overcoming the reality and fear of hypoglycaemia, and appropriate insulin therapy and dose adjustment. As practitioners, the question remains: how do we help patients with type 1 diabetes manage glycaemia while overcoming barriers? In this article, the Global Partnership for Effective Diabetes Management provides practical recommendations to help improve the care of patients with type 1 diabetes.

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Citations
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Journal ArticleDOI

Diabetes Self-Management Smartphone Application for Adults With Type 1 Diabetes: Randomized Controlled Trial

TL;DR: In adjunct to usual care, the use of a diabetes-related smartphone application combined with weekly text-message support from a health care professional can significantly improve glycemic control in adults with type 1 diabetes.
Journal ArticleDOI

Intensive glucose control versus conventional glucose control for type 1 diabetes mellitus

TL;DR: Assessment of the effects of intensive versus conventional glycaemic targets in patients with type 1 diabetes in terms of long-term complications and whether very low, near normoglycaemic values are of additional benefit found evidence for an initial worsening of retinopathy.
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Efficacy and Safety of Canagliflozin, a Sodium–Glucose Cotransporter 2 Inhibitor, as Add-on to Insulin in Patients With Type 1 Diabetes

TL;DR: Canagliflozin provided reductions in HbA1c, body weight, and insulin dose with no increase in hypoglycemia, but increased rates of ketone-related AEs, including DKA, in adults with type 1 diabetes inadequately controlled with insulin.
References
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Journal ArticleDOI

The effect of intensive treatment of diabetes on the development and progression of long-term complications in insulin-dependent diabetes mellitus.

TL;DR: Intensive therapy effectively delays the onset and slows the progression of diabetic retinopathy, nephropathy, and neuropathy in patients with IDDM.
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Intensive diabetes treatment and cardiovascular disease in patients with type 1 diabetes.

TL;DR: Intensive diabetes therapy has long-term beneficial effects on the risk of cardiovascular disease in patients with type 1 diabetes, and changes between treatment groups remained significant after adjusting for these factors.
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Standards of Medical Care in Diabetes—2009

Vittorio Basevi
- 06 Feb 2009 - 
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Efficacy of cholesterol-lowering therapy in 18,686 people with diabetes in 14 randomised trials of statins: a meta-analysis.

TL;DR: Among people with diabetes the proportional effects of statin therapy were similar irrespective of whether there was a prior history of vascular disease and irrespective of other baseline characteristics and should be considered for all diabetic individuals who are at sufficiently high risk of vascular events.
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