Publicado oct 19, 2017



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Pablo Aschner Montoya

Oscar Mauricio Muñoz Velandía

Diana Marcela Girón Cardozo

Olga Milena García Morales

Daniel Gerardo Fernández Ávila

Luz Ángela Casas

Luisa Fernanda Bohórquez Villamizar

Clara Maria Arango Toro

Liliana Carvajal Gutiérrez

Doris Amanda Ramírez De Peña

Juan Guillermo Sarmiento Ramón

Cristian Alejandro Colón

Nestor Fabian Correa González

Pilar Alarcón Robles

Álvaro Andrés Bustamante

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Resumen

Resumen


Introducción: Está demostrado que alcanzar y mantener una hemoglobina glicosilada (HbA1c) del 7 % reduce la incidencia de complicaciones micro y macrovasculares en adultos jóvenes con diabetes mellitus tipo 2 (DMT2). Se ha propuesto que esta meta de manejo debe individualizarse en pacientes mayores de 65 años de edad o en aquellos con antecedente de enfermedad cardiovascular; sin embargo, la evidencia es discutida. Objetivos: Definir los potenciales riesgos y beneficios de la terapia intensificada para DMT2 buscando valores de HbA1 < 7 % en pacientes mayores de 65 años, con comorbilidades significativas y sin estas, y en grupos de pacientes con eventos cardiovasculares previos. Métodos: Se elaboró la guía de práctica clínica, siguiendo los lineamientos de la guía metodológica del Ministerio de Salud y Protección Social colombiano. Se revisó la evidencia disponible de forma sistemática y se formularon las recomendaciones utilizando la metodología GRADE. Conclusiones: En los pacientes con DMT2 mayores de 65 años y en aquellos con antecedente de enfermedad cardiovascular, se recomienda no intensificar el manejo para alcanzar valores de HbA1c cercanos a lo normal (< 6,5 %). Las metas de manejo en el grupo de mayores de 65 años deberán definirse para cada paciente de forma individual de acuerdo con una valoración integral que tenga en cuenta su riesgo de hipoglucemia y pronóstico vital.


 

Keywords

type 2 diabetes mellitus, goals, clinical practice guidelinesdiabetes mellitus tipo 2, metas, guías de práctica clínica

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Cómo citar
Aschner Montoya, P., Muñoz Velandía, O. M., Girón Cardozo, D. M., García Morales, O. M., Fernández Ávila, D. G., Casas, L. Ángela, Bohórquez Villamizar, L. F., Arango Toro, C. M., Carvajal Gutiérrez, L., Ramírez De Peña, D. A., Sarmiento Ramón, J. G., Colón, C. A., Correa González, N. F., Alarcón Robles, P., & Bustamante, Álvaro A. (2017). Guía de práctica clínica para el tratamiento de la diabetes mellitus tipo 2: metas de manejo. Universitas Medica, 58(4). https://doi.org/10.11144/Javeriana.umed58-4.dmmm
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