2016年AACE-ACE共识声明：糖尿病综合管理方案

84ENDOCRINEPRACTICEVol22No.1January2016AACE/ACEConsensusStatementCONSENSUSSTATEMENTBYTHEAMERICANASSOCIATIONOFCLINICALENDOCRINOLOGISTSANDAMERICANCOLLEGEOFENDOCRINOLOGYONTHECOMPREHENSIVETYPE2DIABETESMANAGEMENTALGORITHM–2016EXECUTIVESUMMARYAlanJ.Garber,MD,PhD,FACE1;MartinJ.Abrahamson,MD2;JoshuaI.Barzilay,MD,FACE3;LawrenceBlonde,MD,FACP,FACE4;ZacharyT.Bloomgarden,MD,MACE5;MichaelA.Bush,MD6;SamuelDagogo-Jack,MD,DM,FRCP,FACE7;RalphA.DeFronzo,MD,BMS,MS,BS8;DanielEinhorn,MD,FACP,FACE9;VivianA.Fonseca,MD,FACE10;JeffreyR.Garber,MD,FACP,FACE11;W.TimothyGarvey,MD,FACE12;GeorgeGrunberger,MD,FACP,FACE13;YehudaHandelsman,MD,FACP,FNLA,FACE14;RobertR.Henry,MD,FACE15;IrlB.Hirsch,MD16;PaulS.Jellinger,MD,MACE17;JanetB.McGill,MD,FACE18;JeffreyI.Mechanick,MD,FACN,FACP,FACE,ECNU19;PaulD.Rosenblit,MD,PhD,FNLA,FACE20;GuillermoE.Umpierrez,MD,FACP,FACE21Fromthe1Chair,Professor,DepartmentsofMedicine,BiochemistryandMolecularBiology,andMolecularandCellularBiology,BaylorCollegeofMedicine,Houston,Texas,2BethIsraelDeaconessMedicalCenter,DepartmentofMedicineandHarvardMedicalSchool,Boston,Massachusetts,3DivisionofEndocrinology,KaiserPermanenteofGeorgiaandtheDivisionofEndocrinology,EmoryUniversitySchoolofMedicine,Atlanta,Georgia,4Director,OchsnerDiabetesClinicalResearchUnit,DepartmentofEndocrinology,DiabetesandMetabolism,OchsnerMedicalCenter,NewOrleans,Louisiana,5ClinicalProfessor,MountSinaiSchoolofMedicine,Editor,JournalofDiabetes,NewYork,NewYork,6ClinicalChief,DivisionofEndocrinology,Cedars-SinaiMedicalCenter,AssociateClinicalProfessorofMedicine,GeffenSchoolofMedicine,UCLA,LosAngeles,California,7A.C.MullinsProfessor&Director,DivisionofEndocrinology,DiabetesandMetabolism,UniversityofTennesseeHealthScienceCenter,Memphis,Tennessee,8ProfessorofMedicine,Chief,DiabetesDivision,UniversityofTexasHealthScienceCenteratSanAntonio,SanAntonio,Texas,9ImmediatePastPresident,AmericanCollegeofEndocrinology,Past-President,AmericanAssociationofClinicalEndocrinologists,MedicalDirector,ScrippsWhittierDiabetesInstitute,ClinicalProfessorofMedicine,UCSD,AssociateEditor,JournalofDiabetes,DiabetesandEndocrineAssociates,LaJolla,California,10ProfessorofMedicineandPharmacology,TullisTulaneAlumniChairinDiabetes,Chief,SectionofEndocrinology,TulaneUniversityHealthSciencesCenter,NewOrleans,Louisiana,11EndocrineDivision,HarvardVanguardMedicalAssociates,Boston,Massachusetts,DivisionofEndocrinology,BethIsraelDeaconessMedicalCenter,Boston,Massachusetts,12ProfessorandChair,DepartmentofNutritionSciences,UniversityofAlabamaatBirmingham,Director,UABThisdocumentrepresentstheofficialpositionoftheAmericanAssociationofClinicalEndocrinologistsandAmericanCollegeofEndocrinology.WheretherewerenorandomizedcontrolledtrialsorspecificU.S.FDAlabelingforissuesinclinicalpractice,theparticipatingclinicalexpertsutilizedtheirjudgmentandexperience.Everyeffortwasmadetoachieveconsensusamongthecommitteemembers.Positionstatementsaremeanttoprovideguidance,buttheyarenottobeconsid-eredprescriptiveforanyindividualpatientandcannotreplacethejudgmentofaclinician.DiabetesResearchCenter,MountainBrook,Alabama,13GrunbergerDiabetesInstitute,ClinicalProfessor,InternalMedicineandMolecularMedicine&Genetics,WayneStateUniversitySchoolofMedicine,BloomfieldHills,Michigan,14MedicalDirector&PrincipalInvestigator,MetabolicInstituteofAmerica,President,AmericanCollegeofEndocrinology,Tarzana,California,15ProfessorofMedicine,UniversityofCaliforniaSanDiego,Chief,SectionofDiabetes,Endocrinology&Metabolism,VASanDiegoHealthcareSystem,SanDiego,California,16ProfessorofMedicine,UniversityofWashingtonSchoolofMedicine,Seattle,Washington,17ProfessorofClinicalMedicine,UniversityofMiami,MillerSchoolofMedicine,Miami,Florida,TheCenterforDiabetes&EndocrineCare,Hollywood,Florida,18ProfessorofMedicine,DivisionofEndocrinology,Metabolism&LipidResearch,WashingtonUniversity,St.Louis,Missouri,19ClinicalProfessorofMedicine,Director,MetabolicSupport,DivisionofEndocrinology,Diabetes,andBoneDisease,IcahnSchoolofMedicineatMountSinai,NewYork,NewYork,20ClinicalProfessor,Medicine,DivisionofEndocrinology,Diabetes,Metabolism,UniversityCaliforniaIrvineSchoolofMedicine,Irvine,California,Co-Director,DiabetesOut-PatientClinic,UCIMedicalCenter,Orange,California,Director&PrincipalInvestigator,Diabetes/LipidManagement&ResearchCenter,HuntingtonBeach,California,and21ProfessorofMedicine,EmoryUniversitySchoolofMedicine,Director,EndocrinologySection,GradyHealthSystem,Atlanta,Georgia.AddresscorrespondencetoAmericanAssociationofClinicalEndocrinologists,245RiversideAvenue,Suite200,Jacksonville,FL32202.E-mail:[e-mail]:10.4158/EP151126.CSTopurchasereprintsofthisarticle,pleasevisit:©2016AACE.85Abbreviations:A1C=hemoglobinA1C;AACE=AmericanAssociationofClinicalEndocrinologists;ACCORD=ActiontoControlCardiovascularRiskinDiabetes;ACCORDBP=ActiontoControlCardiovascularRiskinDiabetesBloodPressure;ACEI=angiotensin-convertingenzymeinhibitor;AGI=alpha-glucosidaseinhibitor;apoB=apolipoproteinB;ARB=angiotensinIIreceptorblocker;ASCVD=atheroscl