translate following test to persian: The first iteration of the American Association of Clinical
Endocrinology (AACE) algorithm for glycemic control was published
in 2009 and expanded on the visual guidance provided by
the American College of Endocrinology (ACE)/AACE Diabetes Road
Maps to help clinicians navigate the expanded classes of approved
antihyperglycemic agents.1,2 At that time, thiazolidinediones
(TZDs), alpha-glucosidase inhibitors, metformin, and sulfonylureas
(SUs)/glinides were in use, with the addition of exenatide as well as
dipeptidyl peptidase-4 inhibitors (DPP-4is). The next updatewas in
2013 with publication of the Comprehensive Type 2 Diabetes (T2D)
Management Algorithm, which incorporated new sections on the
management of overweight/obesity, dyslipidemia, and hypertension
(HTN).3 Revisions to this first iteration have been incorporated
on a yearly basis through 2020,4-8 and the task force is grateful for
the contributions and framework provided by previous authors of
the algorithm (see Acknowledgments). In 2022, the AACE published
the Clinical Practice Guideline: Developing a Diabetes Mellitus
Comprehensive Care Plan e 2022 Update,9 which provided 170
revised or new graded recommendations accompanied by detailed,
evidence-based rationales. This 2023 algorithm update builds on
previous versions of the algorithm but with the incorporation of
new management approaches that align with the 2022 AACE clinical
practice guideline (CPG) on diabetes mellitus (DM). The algorithm
is intended as a more concise document than the guideline,
providing easily accessible, visual guidance for decision-making in
the clinic setting. This summary is not intended to iterate all of the
evidence base behind the algorithmic pathways, as this is detailed
in the 2022 AACE DM CPG update.9 Instead, the objective of this
summary is to provide a written guide or “roadmap” through the
graphic depictions of the algorithm contents.
The process for updating the algorithm involved multiple
meetings of task force members/authors between January 2022
and November 2022. Smaller groups focused on specific algorithm
subsections, which were then brought to the complete
task force for discussion and peer review. It was intentional that
a proportion of algorithm task force members overlapped with
the diabetes CPG task force to ensure continuity and alignment
with the 2022 published guideline recommendations. In this
2023 algorithm, there continues to be an emphasis on lifestyle
modification and treatment of overweight/obesity as key pillars
of the management of prediabetes and DM. In addition, the
importance of appropriate management of the atherosclerotic
risk factors of dyslipidemia and HTN is highlighted. One notable
new theme is an obvious emphasis on a complication-centric
approach, beyond glucose levels, to frame decisions regarding
first-line pharmacologic choices for the treatment of persons
with DM, as recommended in the 2022 AACE DM CPG update9
and by other organizations.10,11 However, the task force members/
authors acknowledge that health care disparities and lack of
access to newer medications remain a significant barrier for
some persons with DM.
The algorithm is divided into discrete graphic sections that
outline the principles for management of T2D (Algorithm Fig. 1)
and guide management of adiposity-based chronic disease (ABCD)
(Algorithm Fig. 2), prediabetes (Algorithm Fig. 3), and