Coronary heart disease secondary prevention diabetes mellitus management

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

Type 2 Diabetes Mellitus Management

ACC / AHA 2011 Guidelines - Coronary Heart Disease - Secondary Prevention with Diabetes Mellitus Management (DO NOT EDIT) [1]=

Class I
"1. Care for diabetes should be coordinated with the patient's primary care physician and/or endocrinologist. (Level C)"
"2. Lifestyle modifications including daily physical activity, weight management, blood pressure control, and lipid management are recommended for all patients with diabetes.([[ACC AHA guidelines classification scheme#Level of Evidence|Level B)"
Class IIa

"1. Metformin is an effective first-line pharmacotherapy and can be useful if not contraindicated.(Level A)"

"2. It is reasonable to individualize the intensity of blood sugar–lowering interventions based on the individual patient's risk of hypoglycemia during treatment. (Level C)"

Class IIb

"1. Initiation of pharmacotherapy interventions to achieve target HbA1c may be reasonable. (Level A)"

"2. A target HbA1c of ≤7% may be considered. (Level C)"

"3. Less stringent HbA1c goals may be considered for patients with a history of severe hypoglycemia, limited life expectancy, advanced microvascular or macrovascular complications, or extensive comorbidities, or those in whom the goal is difficult to attain despite intensive therapeutic interventions. (Level C)"

References

  1. Smith SC, Benjamin EJ, Bonow RO, Braun LT, Creager MA, Franklin BA; et al. (2011). "AHA/ACCF Secondary Prevention and Risk Reduction Therapy for Patients with Coronary and other Atherosclerotic Vascular Disease: 2011 update: a guideline from the American Heart Association and American College of Cardiology Foundation". Circulation. 124 (22): 2458–73. doi:10.1161/CIR.0b013e318235eb4d. PMID 22052934.


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