Dysglycemia-Based Chronic Disease: An American Association of Clinical Endocrinologists Position Statement

摘要: The American Association of Clinical Endocrinologists (AACE) has created a dysglycemia-based chronic disease (DBCD) multimorbidity care model consisting four distinct stages along the insulin resistance-prediabetes-type 2 diabetes (T2D) spectrum that are actionable in preventive paradigm to reduce potential impact T2D, cardiometabolic risk, and cardiovascular events. controversy whether there is value, cost-effectiveness, or clinical benefit diagnosing and/or managing prediabetes state resolved by regarding problem, not isolation, but as an intermediate stage continuum progressive with opportunities for multiple concurrent prevention strategies. In this context, 1 represents "insulin resistance," "prediabetes," 3 "type diabetes," 4 "vascular complications." This encourages earliest intervention focusing on structured lifestyle change. Further scientific research may eventually reclassify DBCD from predisease true state. position statement consistent portfolio AACE endocrine models, including adiposity-based disease, prioritize patient-centered care, evidence-based medicine, complexity, multimorbid current health environment, societal mandate higher value attributed good health. Ultimately, transformative changes diagnostic coding reimbursement structures T2D can provide improvements population-based care. Abbreviations: A1C = hemoglobin A1c; Endocrinologists; ABCD disease; CVD FPG fasting plasma glucose; GLP-1 glucagon-like peptide-1; MetS metabolic syndrome; type diabetes.