-
Categories
-
Pharmaceutical Intermediates
-
Active Pharmaceutical Ingredients
-
Food Additives
- Industrial Coatings
- Agrochemicals
- Dyes and Pigments
- Surfactant
- Flavors and Fragrances
- Chemical Reagents
- Catalyst and Auxiliary
- Natural Products
- Inorganic Chemistry
-
Organic Chemistry
-
Biochemical Engineering
- Analytical Chemistry
- Cosmetic Ingredient
-
Pharmaceutical Intermediates
Promotion
ECHEMI Mall
Wholesale
Weekly Price
Exhibition
News
-
Trade Service
*It is only for medical professionals to read for reference.
The Southern Theater General Hospital has put forward a new concept on the role of GLP-1 receptor agonists in the blood glucose management of inpatients
.
At present, the number of diabetic patients in the world continues to rise, and the prevalence of diabetes in China is also increasing year by year.
There are now more than 100 million adult patients
.
As an endocrinologist, the clinical diagnosis of diabetes is often not a single condition, but also complications such as cardiovascular disease (CVD) and chronic kidney disease (CKD)
.
Because of this, the concept of diabetes treatment has gradually shifted from simply lowering blood sugar to comprehensive management in order to prevent or delay the occurrence and progress of comorbidities/complications.
So what are we doing clinically? The "medical community" invited Li Jia, director of the Department of Endocrinology, Southern Theater General Hospital, to explain to us the changes in the concept of hypoglycemia, and also introduced the clinical comprehensive management of diabetes
.
Start with the end, and take care of both the heart and kidney benefits.
Director Li introduced that the era of hypoglycemia has gone through three stages, the 1.
0 stage is pure hypoglycemia, the 2.
0 stage is concerned with the cardiovascular safety of drugs, and now the 3.
0 stage, Emphasizing the comprehensive management of cardiovascular outcomes is to bring certain cardiovascular benefits while reducing blood sugar, consider preventing or delaying complications and maintaining quality of life
.
It can be said that there is a fundamental change
.
The concept of hypoglycemia has undergone tremendous changes from the beginning of pure hypoglycemia to the comprehensive management of cardiovascular outcomes [1-4]
.
The change in the concept of hypoglycemia is also reflected in the latest major guidelines
.
Director Li reminded that from the 2019 European Society of Cardiology (ESC)/European Association for the Study of Diabetes (EASD) "Guidelines for Diagnosis and Treatment of Diabetes/Prediabetes and Cardiovascular Diseases" [5] to the American Diabetes Association (ADA) in 2021 The "Standards for Diabetes Medical Diagnosis and Treatment" [6], and the "Guidelines for the Prevention and Treatment of Type 2 Diabetes in China (2020 Edition)" that we are more concerned about, [3] both emphasize integrated management
.
The "Guidelines for the Prevention and Treatment of Type 2 Diabetes in China (2020 Edition)" pointed out that diabetic patients with atherosclerotic cardiovascular disease (ASCVD) or high-risk factors, heart failure, CKD should be treated when life>
.
This guide not only recommends a treatment path for type 2 diabetes patients with heart and kidney complications, but also includes new drugs
.
Such an update is not only because of the change in people’s thinking, but also because of a large amount of evidence-based evidence that confirms the cardio-renal benefits of GLP-1RA and SGLT-2i these new hypoglycemic drugs, allowing the clinic to have both hypoglycemic and cardiovascular protection.
Treatment
.
"Then some experts call stage 3.
0 start with the end-the ultimate goal of lowering blood sugar is to reduce CVD complications
.
" Director Li said, "The emergence of new blood sugar lowering drugs, such as liraglutide in GLP-1RA, Smeglutide has truly achieved our goal
.
"GLP-1RA helps in -patients to fully control glucose.
" In 2017, China issued the first "Expert Consensus on Blood Glucose Management of Inpatients with Type 2 Diabetes in China".
The use of GLP-1RA is described incisively and vividly.
There is no doubt about the role of insulin in the blood glucose management of patients," Director Li emphasized, "But for the role of GLP-1RA in the blood glucose management of inpatients, I believe there is still a lot of potential that has not been tapped.
Therefore, we also need to explore the issue of medication in this area
.
"The management of diabetes is a comprehensive three-dimensional management.
In addition to controlling blood sugar, we also need to manage blood pressure, blood lipids, weight, uric acid, etc.
, because these are also high-risk factors for CVD complications, so this means that a patient may need to take many kinds of drugs.
Drugs can achieve the purpose of comprehensive management.
In addition to hypoglycemic drugs, you may also need to take antihypertensive drugs, lipid-lowering drugs, uric acid drugs and even weight-loss drugs
.
Director Li pointed out that in this way, the quality of life of patients will be reduced .
Why did you talk about it? Director Li also provided us with ideas for this problem
.
She said that in recent years, the Department of Endocrinology, Southern Theater General Hospital, has paid attention to the 2020 edition of "GLP-1 Receptor Agonists for the Treatment of Type 2 Diabetes" "Consensus of Clinical Experts" and the discussion of the role and status of GLP-1RA in the blood glucose management of inpatients by ADA and EASD
.
At the same time, the department continued to explore GLP-1RA in the blood glucose management of inpatients and found that GLP- As a new type of hypoglycemic drug, 1RA has multiple protective effects.
In addition to being a powerful hypoglycemic agent, it also has comprehensive effects such as lowering blood pressure, lowering lipids, reducing weight, reducing the original insulin dose, and reducing the occurrence of hypoglycemia
.
GLP-1RA for hospitalized patients The advantages of blood sugar management are mainly reflected in the following four aspects: GLP-1RA can effectively lower blood sugar, and benefit from its glucose-dependent insulin secretion mechanism, while stabilizing blood sugar and reducing the occurrence of hypoglycemia; GLP-1RA and The combined use of basal insulin, as well as the combined use of basal insulin and rapid-acting insulin or the use of insulin pumps, can save the amount of insulin; for obese patients, GLP-1RA can achieve a dual-pronged effect on blood sugar and weight loss; there is no exact drug at present For diabetes comorbidities that can be targeted for treatment, such as fatty liver and Alzheimer's disease, GLP-1RA, which is undergoing phase II clinical trials, may bring us good news
.
Closed-loop management, the "Healthy China 2030" plan for the joint control of sugar inside and outside the hospital proposes that chronic diseases require life-long and full-process management.
Except for diabetes, osteoporosis, thyroid disease and gout, etc.
, are all life-long diseases , All need to be managed throughout the process
.
Director Li pointed out that when a patient is hospitalized in the hospital, we can still manage better, but he must be discharged one day, what should I do after he is discharged? This is also an issue of great concern to the department
.
Under this circumstance, the Southern Theater General Hospital formulated a closed-loop joint management in hospital/out-of-hospital
.
During the hospitalization period: Every afternoon, there is an endocrine "small talk about sugar", and the medical staff in the whole department take turns to educate the patients
.
Although the location is simple, the content of the course is very attractive.
A course of 10 days is just the length of the hospital stay for the average patient, so every inpatient check-up and sugar adjustment can obtain a complete knowledge of diabetes management
.
In addition, there are one-to-one small lectures between the nursing team and the patients, and one-on-one counseling and education are provided according to each patient's medical needs, economic level, and complications/comorbidities
.
Out-of-hospital control: Before leaving the hospital, medical staff will ask patients to enter the patient group classified by disease type.
In addition to the diabetes group, there are other chronic metabolic diseases
.
The purpose of forming patient groups of different diseases is also to after discharge, if patients have questions about treatment medication, dietary choices, and any other disease-related issues, they can communicate and guide through the patient group to achieve close control after discharge
.
In addition, for some elderly or busy young people, the department has also prepared a general manual-"Common Endocrine and Metabolic Diseases in Military Officers and Soldiers".
The contents of this manual are personally provided by medical staff in the Department of Endocrinology.
Written and organized into a book, a total of six major diseases are introduced, including diabetes, thyroid, gout, high uric acid, obesity, and osteoporosis
.
Director Li mentioned that the purpose of writing this handbook is to hope that every patient who goes to the clinic can bring their knowledge home, so that they can feel that even if they leave the hospital, they have not left the doctor.
Even if they leave the nurse, he is still there.
Under our care
.
Summary The hypoglycemic concept has gone from a simple hypoglycemic reduction, to focusing on the control of cardiovascular disease risk factors, and then to emphasizing the comprehensive management of cardiovascular outcomes.
Nowadays, we treat diabetes, we need to consider prevention while controlling blood sugar.
Or delay complications and maintain quality of life
.
As a new type of hypoglycemic drug, GLP-1RA has multiple protective factors.
In addition to lowering blood sugar, it also has other effects such as lowering blood pressure, weight loss, lowering cholesterol and so on.
It can play a good role in blood sugar management inside and outside the hospital.
It is worthy of the attention of the endocrinologists
.
Expert introduction Li Jia, deputy chief physician of the Department of Endocrinology, Southern Theater General Hospital, doctor of medicine, postdoctoral, master's tutor, deputy director of the Clinical Endocrine Drug Evaluation Branch of the Chinese Medical Education Association, young committee member of the Endocrinology Branch of the Guangdong Medical Association, deputy of the Diabetes Branch of the Guangzhou Medical Association Chairman of the Osteoporosis Prevention and Rehabilitation Committee of Guangdong Provincial Geriatric Health Association Chairman (preparation) Published more than 40 papers in SCI, core journals, edited, participated in editing, and participated in the translation of 5 monographs.
In recent years, he has hosted more than 5 national and provincial funds.
Served as simultaneous translation of multiple SCI journal review references for the conference: [1] Diabetes Branch of Chinese Medical Association.
Peking University Medical Press.
2011.
[2] Jia Weiping, et al.
Chinese Journal of Diabetes.
2018;10(1) :4-67.
[3] Diabetes Branch of Chinese Medical Association.
Chinese Journal of Diabetes.
2021;13(4):315-409.
[4]Clin Diabetes.
2020 Jan;38(1):10–38.
[5 ]Francesco C, et al.
Eur Heart J.
2020;41(2):255-323.
[6]American Diabetes Association.
Diabetes Care.
2021;44(Suppl 1):S111-24.
- End -"This article It is only used to provide scientific information to medical and health professionals, and does not represent the position of the platform.
" For submission/reprinting/business cooperation, please contact: pengsanmei@yxj.
org.
cn
The Southern Theater General Hospital has put forward a new concept on the role of GLP-1 receptor agonists in the blood glucose management of inpatients
.
At present, the number of diabetic patients in the world continues to rise, and the prevalence of diabetes in China is also increasing year by year.
There are now more than 100 million adult patients
.
As an endocrinologist, the clinical diagnosis of diabetes is often not a single condition, but also complications such as cardiovascular disease (CVD) and chronic kidney disease (CKD)
.
Because of this, the concept of diabetes treatment has gradually shifted from simply lowering blood sugar to comprehensive management in order to prevent or delay the occurrence and progress of comorbidities/complications.
So what are we doing clinically? The "medical community" invited Li Jia, director of the Department of Endocrinology, Southern Theater General Hospital, to explain to us the changes in the concept of hypoglycemia, and also introduced the clinical comprehensive management of diabetes
.
Start with the end, and take care of both the heart and kidney benefits.
Director Li introduced that the era of hypoglycemia has gone through three stages, the 1.
0 stage is pure hypoglycemia, the 2.
0 stage is concerned with the cardiovascular safety of drugs, and now the 3.
0 stage, Emphasizing the comprehensive management of cardiovascular outcomes is to bring certain cardiovascular benefits while reducing blood sugar, consider preventing or delaying complications and maintaining quality of life
.
It can be said that there is a fundamental change
.
The concept of hypoglycemia has undergone tremendous changes from the beginning of pure hypoglycemia to the comprehensive management of cardiovascular outcomes [1-4]
.
The change in the concept of hypoglycemia is also reflected in the latest major guidelines
.
Director Li reminded that from the 2019 European Society of Cardiology (ESC)/European Association for the Study of Diabetes (EASD) "Guidelines for Diagnosis and Treatment of Diabetes/Prediabetes and Cardiovascular Diseases" [5] to the American Diabetes Association (ADA) in 2021 The "Standards for Diabetes Medical Diagnosis and Treatment" [6], and the "Guidelines for the Prevention and Treatment of Type 2 Diabetes in China (2020 Edition)" that we are more concerned about, [3] both emphasize integrated management
.
The "Guidelines for the Prevention and Treatment of Type 2 Diabetes in China (2020 Edition)" pointed out that diabetic patients with atherosclerotic cardiovascular disease (ASCVD) or high-risk factors, heart failure, CKD should be treated when life>
.
This guide not only recommends a treatment path for type 2 diabetes patients with heart and kidney complications, but also includes new drugs
.
Such an update is not only because of the change in people’s thinking, but also because of a large amount of evidence-based evidence that confirms the cardio-renal benefits of GLP-1RA and SGLT-2i these new hypoglycemic drugs, allowing the clinic to have both hypoglycemic and cardiovascular protection.
Treatment
.
"Then some experts call stage 3.
0 start with the end-the ultimate goal of lowering blood sugar is to reduce CVD complications
.
" Director Li said, "The emergence of new blood sugar lowering drugs, such as liraglutide in GLP-1RA, Smeglutide has truly achieved our goal
.
"GLP-1RA helps in -patients to fully control glucose.
" In 2017, China issued the first "Expert Consensus on Blood Glucose Management of Inpatients with Type 2 Diabetes in China".
The use of GLP-1RA is described incisively and vividly.
There is no doubt about the role of insulin in the blood glucose management of patients," Director Li emphasized, "But for the role of GLP-1RA in the blood glucose management of inpatients, I believe there is still a lot of potential that has not been tapped.
Therefore, we also need to explore the issue of medication in this area
.
"The management of diabetes is a comprehensive three-dimensional management.
In addition to controlling blood sugar, we also need to manage blood pressure, blood lipids, weight, uric acid, etc.
, because these are also high-risk factors for CVD complications, so this means that a patient may need to take many kinds of drugs.
Drugs can achieve the purpose of comprehensive management.
In addition to hypoglycemic drugs, you may also need to take antihypertensive drugs, lipid-lowering drugs, uric acid drugs and even weight-loss drugs
.
Director Li pointed out that in this way, the quality of life of patients will be reduced .
Why did you talk about it? Director Li also provided us with ideas for this problem
.
She said that in recent years, the Department of Endocrinology, Southern Theater General Hospital, has paid attention to the 2020 edition of "GLP-1 Receptor Agonists for the Treatment of Type 2 Diabetes" "Consensus of Clinical Experts" and the discussion of the role and status of GLP-1RA in the blood glucose management of inpatients by ADA and EASD
.
At the same time, the department continued to explore GLP-1RA in the blood glucose management of inpatients and found that GLP- As a new type of hypoglycemic drug, 1RA has multiple protective effects.
In addition to being a powerful hypoglycemic agent, it also has comprehensive effects such as lowering blood pressure, lowering lipids, reducing weight, reducing the original insulin dose, and reducing the occurrence of hypoglycemia
.
GLP-1RA for hospitalized patients The advantages of blood sugar management are mainly reflected in the following four aspects: GLP-1RA can effectively lower blood sugar, and benefit from its glucose-dependent insulin secretion mechanism, while stabilizing blood sugar and reducing the occurrence of hypoglycemia; GLP-1RA and The combined use of basal insulin, as well as the combined use of basal insulin and rapid-acting insulin or the use of insulin pumps, can save the amount of insulin; for obese patients, GLP-1RA can achieve a dual-pronged effect on blood sugar and weight loss; there is no exact drug at present For diabetes comorbidities that can be targeted for treatment, such as fatty liver and Alzheimer's disease, GLP-1RA, which is undergoing phase II clinical trials, may bring us good news
.
Closed-loop management, the "Healthy China 2030" plan for the joint control of sugar inside and outside the hospital proposes that chronic diseases require life-long and full-process management.
Except for diabetes, osteoporosis, thyroid disease and gout, etc.
, are all life-long diseases , All need to be managed throughout the process
.
Director Li pointed out that when a patient is hospitalized in the hospital, we can still manage better, but he must be discharged one day, what should I do after he is discharged? This is also an issue of great concern to the department
.
Under this circumstance, the Southern Theater General Hospital formulated a closed-loop joint management in hospital/out-of-hospital
.
During the hospitalization period: Every afternoon, there is an endocrine "small talk about sugar", and the medical staff in the whole department take turns to educate the patients
.
Although the location is simple, the content of the course is very attractive.
A course of 10 days is just the length of the hospital stay for the average patient, so every inpatient check-up and sugar adjustment can obtain a complete knowledge of diabetes management
.
In addition, there are one-to-one small lectures between the nursing team and the patients, and one-on-one counseling and education are provided according to each patient's medical needs, economic level, and complications/comorbidities
.
Out-of-hospital control: Before leaving the hospital, medical staff will ask patients to enter the patient group classified by disease type.
In addition to the diabetes group, there are other chronic metabolic diseases
.
The purpose of forming patient groups of different diseases is also to after discharge, if patients have questions about treatment medication, dietary choices, and any other disease-related issues, they can communicate and guide through the patient group to achieve close control after discharge
.
In addition, for some elderly or busy young people, the department has also prepared a general manual-"Common Endocrine and Metabolic Diseases in Military Officers and Soldiers".
The contents of this manual are personally provided by medical staff in the Department of Endocrinology.
Written and organized into a book, a total of six major diseases are introduced, including diabetes, thyroid, gout, high uric acid, obesity, and osteoporosis
.
Director Li mentioned that the purpose of writing this handbook is to hope that every patient who goes to the clinic can bring their knowledge home, so that they can feel that even if they leave the hospital, they have not left the doctor.
Even if they leave the nurse, he is still there.
Under our care
.
Summary The hypoglycemic concept has gone from a simple hypoglycemic reduction, to focusing on the control of cardiovascular disease risk factors, and then to emphasizing the comprehensive management of cardiovascular outcomes.
Nowadays, we treat diabetes, we need to consider prevention while controlling blood sugar.
Or delay complications and maintain quality of life
.
As a new type of hypoglycemic drug, GLP-1RA has multiple protective factors.
In addition to lowering blood sugar, it also has other effects such as lowering blood pressure, weight loss, lowering cholesterol and so on.
It can play a good role in blood sugar management inside and outside the hospital.
It is worthy of the attention of the endocrinologists
.
Expert introduction Li Jia, deputy chief physician of the Department of Endocrinology, Southern Theater General Hospital, doctor of medicine, postdoctoral, master's tutor, deputy director of the Clinical Endocrine Drug Evaluation Branch of the Chinese Medical Education Association, young committee member of the Endocrinology Branch of the Guangdong Medical Association, deputy of the Diabetes Branch of the Guangzhou Medical Association Chairman of the Osteoporosis Prevention and Rehabilitation Committee of Guangdong Provincial Geriatric Health Association Chairman (preparation) Published more than 40 papers in SCI, core journals, edited, participated in editing, and participated in the translation of 5 monographs.
In recent years, he has hosted more than 5 national and provincial funds.
Served as simultaneous translation of multiple SCI journal review references for the conference: [1] Diabetes Branch of Chinese Medical Association.
Peking University Medical Press.
2011.
[2] Jia Weiping, et al.
Chinese Journal of Diabetes.
2018;10(1) :4-67.
[3] Diabetes Branch of Chinese Medical Association.
Chinese Journal of Diabetes.
2021;13(4):315-409.
[4]Clin Diabetes.
2020 Jan;38(1):10–38.
[5 ]Francesco C, et al.
Eur Heart J.
2020;41(2):255-323.
[6]American Diabetes Association.
Diabetes Care.
2021;44(Suppl 1):S111-24.
- End -"This article It is only used to provide scientific information to medical and health professionals, and does not represent the position of the platform.
" For submission/reprinting/business cooperation, please contact: pengsanmei@yxj.
org.
cn
