Guidelines of European Society of Cardiology and European Association for the Study of Diabetes on Diabetes, Prediabetes and Cardiovascular Diseases (2013)

 
Issue: 1/2014
 
Author: Tankova Tsvetalina
Department of Diabetology, Clinical Center of Endocrinology, Medical University, Sofia
 
Abstract:
 
Both diabetes mellitus and prediabetes – impaired fasting glucose (IFG) and impaired glucose tolerance (IGT) are cardiovascular risk factors. Over 60% of type 2 diabetic patients suffer from cardiovascular disease. More than half the mortality in people with diabetes is related to cardiovascular disease. The growing awareness of the strong relationship between diabetes and cardiovasculardiseases prompted the European Society of Cardiology and the European Association for the Study of Diabetes to collaborate to publish in 2013 joint guidelines on diabetes, prediabetes and cardiovascular diseases. These guidelines are written for the management of the combination of cardiovascular disease (or risk of cardiovascular disease) and diabetes, not as a separate guideline for each condition.

Prevention of cardiovascular disease in diabetes is recommended by lifestyle management, including healthy eating, moderate to vigorous physical activity ≥ 150 min/week, smoking cessation guided by structured advice, as well as glycaemic control and control of blood pressure, dyslipidaemia and platelet function.

The recommended treatment targets for patients with diabetes and IGT and coronary artery disease are as follows: blood pressure < 140/85 mmHg, in case of nephropathy < 130 mmHg; HbA1c generally < 7,0%, on an individual basis < 6,5–6,9%; LDL cholesterol < 1,8 mmol/l or at least a ≥ 50% reduction if this target goal cannot be reached in patients at very high risk, < 2,5 mmol/l in patients at high risk; aspirin 75-160 mg/day; moderate to vigorous physical activity ≥ 150 min/week; weight stabilization in the overweight or obese diabetic patients based on calorie balance; weight reduction in subjects with impaired glucose tolerance to prevent development of diabetes; dietary habits – fat intake < 35% of dietary energy, saturated fat < 10%, monounsaturated fatty acids > 10% of dietary energy; fiber intake > 40g/day (or 20g/1000 Kcal/day); obligatory smoking cessation.

Keywords: diabetes mellitus, coronary artery disease, cardiovascular risk, dyslipidemia, arterial hypertension, heart failure, stroke

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