2012 Зміст Члени Групи з розробки настанови Відбір клінічних настанов для адаптації Синтез настанови Вступ 1 Передумови 2 Визначення 3 Поширеність Цільова аудиторія

R123 Щорічно обговорювати питання еректильної дисфункції з пацієнтами.

R124 Забезпечити оцінку і навчання пацієнтам з еректильною дисфункцією в розпізнаванні сприяючих факторів і у виборі методу лікування.

R125 У разі еректильної дисфункції запропонувати інгібітори фосфодіестерази-5 (вибираючи препарат з низькою вартістю), при відсутності протипоказань.

18.5 Інші аспекти автономної нейропатії

Інші аспекти автономної нейропатії, включаючи діарею, нетримання калу, порушення функції сечового міхура, ортостатичну гіпотензію, аурикулотемпоральний синдром та інші гіпергідрозні розлади, сухі ноги і незрозумілий набряк щиколотки, можуть викликати проблеми діагностики та лікування, а іноді інвалідність.

Інші симптоми можуть бути невизначеними і помилково уявлятися, що вони пов'язані з діабетом, у той час як ушкодження нервів можна також знайти в осіб без симптомів. Об'єднані ознаки є звичайним явищем, можуть посилюватися іншими ліками (наприклад, трициклічними препаратами) і можуть бути проблемними при гіпоглікемії. У пацієнтів з розвиненою автономної нейропатією можуть спостерігатися розвинена ретинопатія, нефропатія та соматична нейропатія.

18.5.2 Від доказів до рекомендацій

Група з розробки настанови розглянула рекомендації на основі думок Настанови NICE діабету 1 типу.²⁶ Переважно вони доцільні й наводяться тільки з деякими редакційними змінами. Визнано, що ці рекомендації розроблені для більшості проблем ідентифікації і діагностики, і що при необхідності фахівці часто виходять за рамки допомоги при діабеті.

 

Алгоритм виявлення і лікування уражень нижніх кінцівок.

19. Напрямки майбутніх досліджень

Метформін: що підтверджують дослідження переваг з точки зору вивчення серцево-судинних результатів.

Дослідження ролі похідних сульфонілсечовини на початку комбінованого прийому.

Довгострокові дослідження ролі самоконтролю як частина комплексу з навчанням пацієнтів і методами лікування, що використовувалися для досягнення мети.

Комбінований прийом ІАПФ і блокаторів рецепторів ангіотензин IIна початку діабетичної нефропатії.

Порівняльні дослідження трициклічних препаратів, дулоксетину, габапентину і прегабаліну.

Використана література

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