摘要
In late 2018, the ADA and the EASD have published a consensus for diabetes management. Later, the ADA standards of medical care in diabetes adapted the content of the consensus. Patient centered collaborative care is emphasized, and the goal of care is to prevent complications as well as to optimize quality of life. Several key steps in the decision cycle are suggested. Metformin remains the first-line therapy for type 2 diabetes patients. For the second-line medication, the consensus suggests that the presence of established atherosclerotic cardiovascular diseases (ASCVD) or chronic kidney diseases (CKD) should be considered first, and SGLT2 inhibitors and GLP-1 receptor agonists are recommended in the presence of ASCVD or CKD. Besides, the consensus also suggest choices of second-line medications based on different goals, such as to minimize weight gain, to avoid hypoglycemia and to consider the cost. For injection therapy, the consensus also provided an algorithm for the choice among them. In 2019, the AACE updates their clinical practice guideline about type 2 diabetes management. ASCVD is also an important consideration in the guideline. In this talk, I will introduce the content of the ADA/EASD consensus and the AACE guideline first. Then, I will also discuss the pros and cons of the two international guidelines. Then I will introduce DAROC clinical practice guidelines for diabetes care 2018-2019.