{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2024,8,6]],"date-time":"2024-08-06T23:29:18Z","timestamp":1722986958496},"reference-count":2,"publisher":"Akademiai Kiado Zrt.","issue":"31","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Orvosi Hetilap"],"published-print":{"date-parts":[[2019,8]]},"abstract":"<jats:p> Abstract: <\/jats:p><jats:p> Type 2 diabetes \u2013 due to its natural course \u2013 should be considered as a progressive chronic disease. Owing to this fact, antihyperglycemic treatment should be continuously increased stepwise in order to achieve proper glycemic control. Lifestyle modification should be initiated immediately after manifestation, shortly followed by metformin monotherapy, and later, dual or triple combinations and, finally, injectable derivatives \u2013 only insulin in the past \u2013 should be used for appropriate glycemic control. Guidelines about treatment approach of patients with type 2 diabetes unequivocally emphasize and describe in detail the need of treatment intensification, in other words, stepwise escalation in clinical practice. In the last couple of years, evidences provided that step down therapy, simplification of complex treatment regimens should also be considered in certain cases. This approach was generally called de-escalation in antihyperglycemic treatment which should be considered in patients with type 2 diabetes 1) after bariatric (metabolic) surgery; 2) with significant weight reduction irrespective of its origin; 3) with complex insulin regimens where re-evaluation of this treatment was missed; 4) with continuously decreasing renal function; 5) among elderly patients with comorbidities; 6) in social deprivation. In this article, data about therapeutic de-escalation of antihyperglycemic treatment in patients with type 2 diabetes and first experiences with this treatment approach are summarized. Orv Hetil. 2019; 160(31): 1207\u20131215. <\/jats:p>","DOI":"10.1556\/650.2019.31488","type":"journal-article","created":{"date-parts":[[2019,7,28]],"date-time":"2019-07-28T06:52:12Z","timestamp":1564296732000},"page":"1207-1215","source":"Crossref","is-referenced-by-count":3,"title":["Az antihyperglykaemi\u00e1s ter\u00e1pia deeszkal\u00e1ci\u00f3ja 2-es                     t\u00edpus\u00fa diabetesben \u2013 amikor a kevesebb t\u00f6bb"],"prefix":"10.1556","volume":"160","author":[{"given":"Gy\u00f6rgy","family":"Jermendy","sequence":"first","affiliation":[{"name":"Bajcsy-Zsilinszky K\u00f3rh\u00e1z Budapest, Magl\u00f3di \u00fat 89\u201391., 1106"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"425","reference":[{"key":"R12","doi-asserted-by":"publisher","DOI":"10.1007\/s11894-018-0643-8"},{"key":"R27","doi-asserted-by":"publisher","DOI":"10.1038\/s41366-019-0320-5"}],"container-title":["Orvosi Hetilap"],"original-title":[],"language":"hu","link":[{"URL":"https:\/\/www.akademiai.com\/doi\/pdf\/10.1556\/650.2019.31488","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2019,7,28]],"date-time":"2019-07-28T06:52:16Z","timestamp":1564296736000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.akademiai.com\/doi\/10.1556\/650.2019.31488"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,8]]},"references-count":2,"journal-issue":{"issue":"31","published-print":{"date-parts":[[2019,8]]}},"alternative-id":["10.1556\/650.2019.31488"],"URL":"https:\/\/doi.org\/10.1556\/650.2019.31488","relation":{},"ISSN":["0030-6002","1788-6120"],"issn-type":[{"value":"0030-6002","type":"print"},{"value":"1788-6120","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,8]]}}}