nach oben

Endocrine

Erschienen in:

22.10.2015 | Review

The role of patient education in the prevention and management of type 2 diabetes: an overview

verfasst von: Adriana Coppola, Loredana Sasso, Annamaria Bagnasco, Andrea Giustina, Carmine Gazzaruso

Erschienen in: Endocrine | Ausgabe 1/2016

Einloggen, um Zugang zu erhalten

Abstract

The management of type 2 diabetes mellitus includes ability and empowerment of the patient to change lifestyle, maintain an adequate diet and physical activity, manage the disease, and follow a specific program of periodic medical checks and education sessions. In addition, the patient should be able to correctly identify and adequately solve problems related to the disease and actively collaborate with the healthcare system. To obtain these goals, therapeutic patient education (TPE) is now considered a crucial element not only in the treatment but also in the prevention of type 2 diabetes. Several trials showed that TPE is able to improve clinical, lifestyle, and psycho-social outcomes. Nevertheless, studies have not clarified the ideal characteristics of a comprehensive patient education program in clinical practice. Other work is needed to answer open questions regarding the type of PTE (individual or group education), themes, frequency and number of education sessions, contact time between educator and patient, background of educators, use of new technologies, and barriers to self-management. The present review discusses these points on the basis of the most recent data of the literature.

H. Jones, L.D. Berard, G. MacNeill, D. Whitham, C. Yu, Canadian Diabetes Association Clinical Practice Guidelines Expert Committee. Self-management education. Can. J. Diabetes 37, S26–S30 (2014)CrossRef

M.A. Powers, J. Bardsley, M. Cypress, P. Duker, M.M. Funnell, A.H. Fischl, M.D. Maryniuk, L. Siminerio, E. Vivian, Diabetes self-management education and support in type 2 diabetes: a joint position statement of the American Diabetes Association, the American Association of Diabetes Educators, and the Academy of Nutrition and Diabetics. Diabetes Care 38, 1372–1382 (2015)CrossRefPubMed

L. Haas, M. Maryniuk, J. Beck, C.E. Cox, P. Duker, L. Edwards, E.B. Fisher, L. Hanson, D. Kent, L. Kolb, S. McLaughlin, E. Orzeck, J.D. Piette, A.S. Rhinehart, R. Rothman, S. Sklaroff, D. Tomky, G. Youssef, Standards Revision Task Force, National standards for self-management education and support. Diabetes Care 37(Suppl 1), S144–S153 (2014)CrossRefPubMed

International Diabetes Federation, International standards for diabetes education, 3rd edn (2009), www.idf.org. Accessed 27 Dec 2014

G. Danaei, M.M. Finucane, Y. Lu, G.M. Singh, M.J. Cowan, C.J. Paciorek, J.K. Lin, F. Farzadfar, Y.H. Khang, G.A. Stevens, M. Rao, M.K. Ali, L.M. Riley, C.A. Robinson, M. Ezzati, Global Burden of Metabolic Risk Factors of Chronic Diseases Collaborating Group (Blood Glucose), National, regional, and global trends in fasting plasma glucose and diabetes prevalence since 1980: systematic analysis of health examination surveys and epidemiological studies with 370 country-years and 2.7 million participants. Lancet 378, 31–40 (2011)CrossRefPubMed

International Diabetes Federation, Diabetes atlas, http://www.idf.org/diabetesatlas/5e/the-global-burden. Accessed 14 Nov 2014

N. Sarwar, P. Gao, S.R. Seshasai, R. Gobin, S. Kaptoge, Angelantonio E. Di, E. Ingelsson, D.A. Lawlor, E. Selvin, M. Stampfer, C.D. Stehouwer, S. Lewington, L. Pennells, A. Thompson, N. Sattar, I.R. White, K.K. Ray, J. Danesh, Emerging Risk Factors Collaboration, Diabetes mellitus, fasting blood glucose concentration, and risk of vascular disease: a collaborative meta-analysis of 102 prospective studies. Lancet 375(9733), 2215–2222 (2010)CrossRefPubMed

S.R. Seshasai, S. Kaptoge, A. Thompson, Angelantonio E. Di, P. Gao, N. Sarwar, P.H. Whincup, K.J. Mukamal, R.F. Gillum, I. Holme, I. Njølstad, A. Fletcher, P. Nilsson, S. Lewington, R. Collins, V. Gudnason, S.G. Thompson, N. Sattar, E. Selvin, F.B. Hu, J. Danesh, Emerging Risk Factors Collaboration, Diabetes mellitus, fasting glucose, and risk of cause-specific death. N. Engl. J. Med. 364(9), 829–841 (2011)CrossRefPubMed

A.D. Deshpande, M. Harris-Hayes, M. Schootman, Epidemiology of diabetes and diabetes-related complications. Phys. Ther. 88(11), 1254–1264 (2008)CrossRefPubMedPubMedCentral

10.

L. Chen, D.J. Magliano, P.Z. Zimmet, The worldwide epidemiology of type 2 diabetes mellitus—present and future perspectives. Nat. Rev. Endocrinol. 8(4), 228–236 (2012)CrossRef

11.

M. Bergman, Pathophysiology of prediabetes and treatment implications for the treatment of type 2 diabetes mellitus. Endocrine 43, 504–513 (2013)CrossRefPubMed

12.

M. Bergman, Inadequacies of current approaches to prediabetes and diabetes prevention. Endocrine 44(3), 623–633 (2013)CrossRefPubMed

13.

N.G. Forouhi, N.J. Wareham, The EPIC-InterAct Study: a study of the interplay between genetic and lifestyle behavioral factors on the risk of type 2 diabetes in European populations. Curr. Nutr. Rep. 3(4), 355–363 (2014)CrossRefPubMedPubMedCentral

14.

M. Buysschaert, J.L. Medina, M. Bergman, A. Shah, J. Lonier, Prediabetes and associated disorders. Endocrine 48(2), 371–393 (2015)CrossRefPubMed

15.

Y. Li, S.H. Ley, D.K. Tobias, S.E. Chiuve, T.J. VanderWeele, J.W. Rich-Edwards, G.C. Curhan, W.C. Willett, J.E. Manson, F.B. Hu, L. Qi, Birth weight and later life adherence to unhealthy lifestyles in predicting type 2 diabetes: prospective cohort study. BMJ 351, h3673 (2015). doi:10.1136/bmj.h3672

16.

R.E. Glasgow, R.G. Hiss, R.M. Anderson, N.M. Friedman, R.A. Hayward, D.G. Marrero, C.B. Taylor, F. Vinicor, Report of the Health Care Delivery Work Group: behavioral research related to the establishment of a chronic disease for diabetes care. Diabetes Care 24, 124–130 (2001)CrossRefPubMed

17.

M. Stellefson, K. Dipnarine, C. Stopka, The chronic care model and diabetes management in US primary care settings: a systematic review. Prev. Chronic Dis. 10, 120180 (2013)CrossRef

18.

J. Jarvis, T.C. Skinner, M.E. Carey, M.J. Davies, How can structured self-management patient education improve outcomes in people with type 2 diabetes? Diabetes Obes. Metab. 12, 12–19 (2010)CrossRefPubMed

19.

X. Debussche, F. Collin, A. Fianu, M. Balcou-Debussche, I. Fouet-Rosiers, M. Koleck, F. Favier, Structured self-management education maintained over two years in insufficiently controlled type 2 diabetes patients: the ERMIES randomised trial in Reunion Island. Cardiovasc. Diabetol. 11, 91 (2012)CrossRefPubMedPubMedCentral

20.

T. Deakin, C.E. McShane, J.E. Cade, Williams RD Group based training for self-management strategies in people with type 2 diabetes mellitus. Cochrane Database Syst. Rev. 2, CD003417 (2005)PubMed

21.

M. Trento, S. Gamba, L. Gentile, G. Grassi, V. Miselli, G. Morone, P. Passera, L. Tonutti, M. Tomalino, P. Bondonio, F. Cavallo, M. Porta, ROMEO Investigators, Rethink Organization to iMprove Education and Outcomes (ROMEO): a multicenter randomized trial of lifestyle intervention by group care to manage type 2 diabetes. Diabetes Care 33, 745–747 (2010)CrossRefPubMedPubMedCentral

22.

M. Trento, P. Passera, E. Borgo, M. Tomalino, M. Bajardi, F. Cavallo, M. Porta, A 5-year randomized controlled study of learning, problem solving ability, and quality of life modifications in people with type 2 diabetes managed by group care. Diabetes Care 27, 670–675 (2004)CrossRefPubMed

23.

A. Steinsbekk, L.Ø. Rygg, M. Lisulo, M.B. Rise, A. Fretheim, Group based diabetes self-management education compared to routine treatment for people with type 2 diabetes mellitus. A systematic review with meta-analysis. BMC Health Serv. Res. 12, 213 (2012)CrossRefPubMedPubMedCentral

24.

S.A. Duke, S. Colagiuri, R. Colagiuri, Individual patient education for people with type 2 diabetes mellitus. Cochrane Database Syst. Rev. 1, CD005268 (2009)PubMed

25.

J. Sperl-Hillen, S. Beaton, O. Fernandes, A. Von Worley, G. Vazquez-Benitez, E. Parker, A. Hanson, J. Lavin-Tompkins, P. Glasrud, H. Davis, K. Adams, W. Parsons, C.V. Spain, Comparative effectiveness of patient education methods for type 2 diabetes: a randomized controlled trial. Arch. Int. Med. 171(22), 2001–2010 (2011)CrossRef

26.

C.K. Wong, W.C. Wong, C.L. Lam, Y.F. Wan, W.H. Wong, K.L. Chung, D. Dai, E.L. Tsui, D.Y. Fong, Effects of Patient Empowerment Programme (PEP) on clinical outcomes and health service utilization in type 2 diabetes mellitus in primary care: an observational matched cohort study. PLoS ONE 9(5), e95328 (2014)CrossRefPubMedPubMedCentral

27.

C.K. Wong, W.C. Wong, Y.F. Wan, A.K. Chan, K.L. Chung, F.W. Chan, C.L. Lam, Patient Empowerment Programme in primary care reduced all-cause mortality and cardiovascular diseases in patients with type 2 diabetes mellitus: a population-based propensity-matched cohort study. Diabetes Obes. Metab. 17(2), 128–135 (2015)CrossRefPubMed

28.

S.J. Healy, D. Black, C. Harris, A. Lorenz, K.M. Dungan, Inpatient diabetes education is associated with less frequent hospital readmission among patients with poor glycemic control. Diabetes Care 36, 2960–2967 (2013)CrossRefPubMedPubMedCentral

29.

M.J. Davies, S. Heller, T.C. Skinner, M.J. Campbell, M.E. Carey, S. Cradock, H.M. Dallosso, H. Daly, Y. Doherty, S. Eaton, C. Fox, L. Oliver, K. Rantell, G. Rayman, K. Khunti, Diabetes Education and Self Management for Ongoing and Newly Diagnosed Collaborative, Effectiveness of the diabetes education and self management for ongoing and newly diagnosed (DESMOND) programme for people with newly diagnosed type 2 diabetes: cluster randomised controlled trial. BMJ 336(7642), 491–495 (2008)CrossRefPubMedPubMedCentral

30.

K. Khunti, L.J. Gray, T. Skinner, M.E. Carey, K. Realf, H. Dallosso, H. Fisher, M. Campbell, S. Heller, M.J. Davies, Effectiveness of a diabetes education and self management programme (DESMOND) for people with newly diagnosed type 2 diabetes mellitus: three year follow-up of a cluster randomised controlled trial in primary care. BMJ 344, e2333 (2012)CrossRefPubMedPubMedCentral

31.

R.G. Weaver, B.R. Hemmelgarn, D.M. Rabi, P.M. Sargious, A.L. Edwards, B.J. Manns, M. Tonelli, M.T. James, Association between participation in a brief diabetes education programme and glycemic control in adults with newly diagnosed diabetes. Diabet. Med. 31, 1610–1614 (2014)CrossRefPubMed

32.

K. Esposito, D. Giugliano, Healthy lifestyle for metabolic health: no more excuse! Endocrine 46(2), 176–178 (2014)CrossRefPubMed

33.

K. Esposito, P. Chiodini, M.I. Maiorino, G. Bellastella, D. Panagiotakos, D. Giugliano, Which diet for prevention of type 2 diabetes? A meta-analysis of prospective studies. Endocrine 47(1), 107–116 (2014)CrossRefPubMed

34.

G.N. Thomas, C.Q. Jiang, S. Taheri, Z.H. Xiao, B. Tomlinson, B.M.Y. Cheung, T.H. Lam, A.H. Barnett, K.K. Cheng, A systematic review of lifestyle modification and glucose intolerance in the prevention of type 2 diabetes. Curr. Diabetes Rev. 6, 378–387 (2010)CrossRefPubMed

35.

W.C. Knowler, E. Barrett-Connor, S.E. Fowler, R.F. Hamman, J.M. Lachin, E.A. Walker, D.M. Nathan, Diabetes Prevention Program Research Group, Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. N. Engl. J. Med. 346, 393–403 (2002)CrossRefPubMed

36.

A. Glechner, J. Harreiter, G. Gartlehner, S. Rohleder, A. Kautzky, J. Tuomilehto, M. Van Noord, A. Kaminski-Hartenthaler, A. Kautzky-Willer, Sex-specific differences in diabetes prevention: a systematic review and meta-analysis. Diabetologia 58(2), 242–254 (2015)CrossRefPubMed

37.

E.M. Balk, A. Earley, G. Raman, E.A. Avendano, A.G. Pittas, P.L. Remington, Combined diet and physical activity promotion programs to prevent type 2 diabetes among persons at increased risk: a systematic review for the Community Preventive Services Task Force. Ann. Intern. Med. (2015). doi:10.7326/M15-0452 PubMedCentral

38.

N.P. Pronk, P.L. Remington, on behalf of the Community Preventive Services Task Force, Combined diet and physical activity promotion programs for prevention of diabetes: Community Preventive Services Task Force recommendation statement. Ann. Intern. Med. (2015). doi:10.7326/M15-1029

39.

S.B. Koivusalo, K. Rono, M.M. Klemetti, R.P. Roine, J. Lindstrom, M. Erkkola, R.J. Kaaja, M. Poyhonen-Alho, A. Tiitinen, E. Huvinen, S. Andersson, H. Laivuori, A. Valkama, J. Meinila, H. Kautiainen, J.G. Eriksson, B. Stach-Lempinen, Gestational diabetes mellitus can be prevented by lifestyle intervention: the Finnish Gestational Diabetes Prevention Study (RADIEL): a randomized controlled trial. Diabetes Care (2015)

40.

E.W. Gregg, H. Chen, L.E. Wagenknecht, J.M. Clark, L.M. Delahanty, J. Bantle, H.J. Pownall, K.C. Johnson, M.M. Safford, A.E. Kitabchi, F.X. Pi-Sunyer, R.R. Wing, A.G. Bertoni, Look AHEAD Research Group, Association of an intensive lifestyle intervention with remission of type 2 diabetes. JAMA 308(23), 2489–2496 (2012)CrossRefPubMedPubMedCentral

41.

L. Chen, J.H. Pei, J. Kuang, H.M. Chen, Z. Chen, Z.W. Li, H.Z. Yang, Effect of lifestyle intervention in patients with type 2 diabetes: a meta-analysis. Metabolism 64, 338–347 (2015)CrossRefPubMed

42.

E.S. Schellenberg, D.M. Dryden, B. Vandermeer, C. Ha, C. Korownyk, Lifestyle interventions for patients with and at risk for type 2 diabetes: a systematic review and meta-analysis. Ann. Intern. Med. 159(8), 543–551 (2013)CrossRefPubMed

43.

L. Dube, S. Van den Broucke, M. Housiaux, W. Dhoore, K. Rendall-Mkosi, Type 2 diabetes self-management education programs in high and low mortality developing countries: a systematic review. Diabetes Educ. 41(1), 69–85 (2015)CrossRefPubMed

44.

B. Ahren, Avoiding hypoglycemia: a key to success for glucose-lowering therapy in type 2 diabetes. Vasc Health Risk Manag. 9, 155–163 (2013)CrossRefPubMedPubMedCentral

45.

K. Khunti, M. Davies, A. Majeed, B.L. Thorsted, M.L. Wolden, S.K. Paul, Hypoglycemia and risk of cardiovascular disease and all-cause mortality in insulin-treated people with type 1 and type 2 diabetes: a cohort study. Diabetes Care 38(2), 316–322 (2015)CrossRefPubMed

46.

C. Gazzaruso, A. Coppola, C. Luppi, A. Giustina, S.B. Solerte, Effect of different diabetes mellitus treatments on functional decline and death in elderly adults with diabetes mellitus. J. Am. Geriatr. Soc. 61(4), 666–667 (2013)CrossRefPubMed

47.

C. Gazzaruso, A. Coppola, A. Giustina, Erectile dysfunction and coronary artery disease in patients with diabetes. Curr. Diabetes Rev. 7(2), 143–147 (2011)CrossRefPubMed

48.

C. Gazzaruso, A. Pujia, S.B. Solerte, E.D. Amici, E. Emanuele, C. Falcone, D. Geroldi, A. Giustina, A. Garzaniti, Erectile dysfunction and angiographic extent of coronary artery disease in type II diabetic patients. Int. J. Impotence Res. 18(3), 311–315 (2006)CrossRef

49.

C. Gazzaruso, A. Coppola, T. Montalcini, C. Valenti, A. Garzaniti, G. Pelissero, F. Salvucci, P. Gallotti, A. Pujia, C. Falcone, S.B. Solerte, A. Giustina, Erectile dysfunction can improve the effectiveness of the current guidelines for the screening for asymptomatic coronary artery disease in diabetes. Endocrine 40(2), 273–279 (2011)CrossRefPubMed

50.

J. Apelqvist, Diagnostics and treatment of the diabetic foot. Endocrine 41(3), 384–397 (2012)CrossRefPubMed

51.

C. Gazzaruso, A. Coppola, T. Montalcini, E. Baffero, A. Garzaniti, G. Pelissero, S. Collaviti, A. Grugnetti, P. Gallotti, A. Pujia, S.B. Solerte, A. Giustina, Lipoprotein(a) and homocysteine as genetic risk factors for vascular and neuropathic diabetic foot in type 2 diabetes mellitus. Endocrine 41(1), 89–95 (2012)CrossRefPubMed

52.

C. Gazzaruso, A. Coppola, C. Falcone, C. Luppi, T. Montalcini, E. Baffero, P. Gallotti, A. Pujia, S.B. Solerte, G. Pelissero, A. Giustina, Transcutaneous oxygen tension as a potential predictor of cardiovascular events in type 2 diabetes: comparison with ankle-brachial index. Diabetes Care 36(6), 1720–1725 (2013)CrossRefPubMedPubMedCentral

53.

C. Gazzaruso, A. Coppola, S. Collaviti, C.M. Saluzzo, F. Furlani, P. Gallotti, J. Clerissi, B.S. Solerte, A. Giustina, Percutaneous transluminal angioplasty for critical limb ischemia in very elderly diabetic patients. Aging Clin. Exp. Res. 25(2), 225–228 (2013)CrossRefPubMed

54.

N.B. Lincoln, K.A. Radford, F.L. Game, W.J. Jeffcoate, Education for secondary prevention of foot ulcers in people with diabetes: a randomized controlled trial. Diabetologia 51, 1954–1961 (2008)CrossRefPubMed

55.

J.A.N. Dorresteijn, D.M.W. Kriegsman, W.J.J. Assendelft, G.D. Valk, Patient education for preventing diabetic foot ulceration. Cochrane Database Syst. Rev. 10, CD001488 (2012)PubMed

56.

S.L. Norris, J. Lau, S.J. Smith, C.H. Schmid, M.M. Engelgau, Self-management education for adults with type 2 diabetes: a meta-analysis of the effect on glycemic control. Diabetes Care 25(7), 1159–1171 (2002)CrossRefPubMed

57.

T.L. Gary, J.M. Genkinger, E. Guallar, M. Peyrot, F.L. Brancati, Meta-analysis of randomized educational and behavioral interventions in type 2 diabetes. Diabetes Educ. 29(3), 488–501 (2003)CrossRefPubMed

58.

K. Pal, S.V. Eastwood, S. Michie, A. Farmer, M.L. Barnard, R. Peacock, B. Wood, P. Edwards, E. Murray, Computer-based interventions to improve self-management in adults with type 2 diabetes: a systematic review and meta-analysis. Diabetes Care 37(6), 1759–1766 (2014)CrossRefPubMed

59.

A.J. Ahola, P.H. Groop, Barriers to self-management of diabetes. Diabet. Med. 30(4), 413–420 (2013)CrossRefPubMed

60.

V. Fiore, M. Marci, A. Poggi, V.A. Giagulli, B. Licchelli, M. Iacoviello, E. Guastamacchia, G. De Pergola, V. Triggiani, The association between diabetes and depression: a very disabling condition. Endocrine 48(1), 14–24 (2015)CrossRefPubMed

61.

R.J. Walker, B.L. Smalls, J.A. Campbell, J.L. Strom Williams, L.E. Egede, Impact of social determinants of health on outcomes for type 2 diabetes: a systematic review. Endocrine 47(1), 29–48 (2014)CrossRefPubMed

62.

A.Z. Dawson, R.J. Walker, J.A. Campbell, L.E. Egede, Effect of perceived racial discrimination on self-care behaviors, glycemic control, and quality of life in adults with type 2 diabetes. Endocrine 49(2), 422–428 (2015)CrossRefPubMed

63.

J. Creamer, M. Attridge, M. Ramsden, R. Cannings-John, K. Hawthorne, Culturally appropriate health education for Type 2 diabetes in ethnic minority groups: an updated Cochrane Review of randomized controlled trials. Diabet. Med. (2015). doi:10.1111/dme.12865 PubMed

64.

M.T. Kim, H.R. Han, H.J. Song, J.E. Lee, J. Kim, J.P. Ryu, K.B. Kim, A community-based, culturally tailored behavioral intervention for Korean Americans with type 2 diabetes. Diabetes Educ. 35(6), 986–994 (2009)CrossRefPubMedPubMedCentral

65.

C.D. Samuel-Hodge, T.C. Keyserling, S. Park, L.F. Johnston, Z. Gizlice, S.I. Bangdiwala, A randomized trial of a church-based diabetes self-management program for African Americans with type 2 diabetes. Diabetes Educ. 35(3), 439–454 (2009)CrossRefPubMed

66.

L. Fisher, R.E. Glasgow, A call for more effectively integrating behavioral and social science principles into comprehensive diabetes care. Diabetes Care 30(10), 2746–2749 (2007)CrossRefPubMed

67.

E.W. Gregg, X. Zhuo, Y.J. Cheng, A.L. Albright, K.M. Narayan, T.J. Thompson, Trends in lifetime risk and years of life lost due to diabetes in the USA, 1985–2011: a modelling study. Lancet Diabetes Endocrinol. 2(11), 867–874 (2014)CrossRefPubMed

68.

T.M. Dall, W. Yang, P. Halder, B. Pang, M. Massoudi, N. Wintfeld, A.P. Semilla, J. Franz, P.F. Hogan, The economic burden of elevated blood glucose levels in 2012: diagnosed and undiagnosed diabetes, gestational diabetes mellitus, and prediabetes. Diabetes Care 37, 3172–3179 (2014)CrossRefPubMed

69.

W.H. Herman, S.L. Edelstein, R.E. Ratner, M.G. Montez, R.T. Ackermann, T.J. Orchard, M.A. Foulkes, P. Zhang, C.D. Saudek, M.B. Brown, Diabetes Prevention Program Research Group, Effectiveness and cost-effectiveness of diabetes prevention among adherent participants. Am. J. Manag. Care. 19(3), 194–202 (2013)PubMedPubMedCentral

70.

M. Gillett, H.M. Dallosso, S. Dixon, A. Brennan, M.E. Carey, M.J. Campbell, S. Heller, K. Khunti, T.C. Skinner, M.J. Davies, Delivering the diabetes education and self management for ongoing and newly diagnosed (DESMOND) programme for people with newly diagnosed type 2 diabetes: cost effectiveness analysis. BMJ 341, c4093 (2010)CrossRefPubMedPubMedCentral

71.

R. Li, P. Zhang, S. Chattopadhyay, E.W. Gregg, A. Albright, D. Hopkins, N.P. Pronk, Economic evaluation of combined diet and physical activity promotion programs to prevent type 2 diabetes among persons at increased risk: a systematic review for the Community Preventive Services Task Force. Ann. Intern. Med. (2015). doi:10.7326/M15-0469

72.

S.A. Boren, K.A. Fitzner, P.S. Panhalkar, J.E. Specker, Costs and benefits associated with diabetes education: a review of the literature. Diabetes Educ. 35(1), 72–96 (2009)CrossRefPubMed

Titel: The role of patient education in the prevention and management of type 2 diabetes: an overview
verfasst von: Adriana Coppola
Loredana Sasso
Annamaria Bagnasco
Andrea Giustina
Carmine Gazzaruso
Publikationsdatum: 22.10.2015
Verlag: Springer US
Erschienen in: Endocrine / Ausgabe 1/2016
Print ISSN: 1355-008X
Elektronische ISSN: 1559-0100
DOI: https://doi.org/10.1007/s12020-015-0775-7

Leitlinien kompakt für die Innere Medizin

Mit medbee Pocketcards sicher entscheiden.

^{Seit 2022 gehört die medbee GmbH zum Springer Medizin Verlag}

Kostenlos registrieren

Neu im Fachgebiet Innere Medizin

19.04.2024 | Vorhofflimmern | Nachrichten

Update Innere Medizin

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen

Live-Webinar: Aktuelle Leitlinien bei Herz-Kreislauf-Erkrankungen

Springer Medizin

The role of patient education in the prevention and management of type 2 diabetes: an overview

Abstract

Leitlinien kompakt für die Innere Medizin

Neu im Fachgebiet Innere Medizin

Parodontalbehandlung verbessert Prognose bei Katheterablation

Antihypertensiva schützen auch alte Menschen noch vor Demenz

Stereotaktische Radiatio schlägt konventionelle Bestrahlung

Denken Sie bei starker Blutung auch an die Hemmkörper-Hämophilie

Update Innere Medizin

Live-Webinar: Aktuelle Leitlinien bei Herz-Kreislauf-Erkrankungen

Springer Medizin

Abstract

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

Weitere Artikel der Ausgabe 1/2016

Long-term effects of growth hormone (GH) replacement therapy on hematopoiesis in a large cohort of children with GH deficiency

Association of cord blood des-acyl ghrelin with birth weight, and placental GHS-R1 receptor expression in SGA, AGA, and LGA newborns

Bone resorption following weight loss surgery is associated with treatment procedure and changes in secreted Wnt antagonists

Twenty years of gastroenteropancreatic neuroendocrine tumors: is reclassification worthwhile and feasible?

Alleviation of high-fat diet-induced atherosclerosis and glucose intolerance by a novel GLP-1 fusion protein in ApoE−/− mice

GALNT2 mRNA levels are associated with serum triglycerides in humans

Leitlinien kompakt für die Innere Medizin

Neu im Fachgebiet Innere Medizin

Parodontalbehandlung verbessert Prognose bei Katheterablation

Antihypertensiva schützen auch alte Menschen noch vor Demenz

Stereotaktische Radiatio schlägt konventionelle Bestrahlung

Denken Sie bei starker Blutung auch an die Hemmkörper-Hämophilie

Update Innere Medizin