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Appendix 5. Coronary risk tables: REGICOR Coronary risk table calibrated for the Spanish population in males and females (from Marrugat J, et al. Rev Esp Cardiol. 2003; 56: 253-261) 144 CLINICAL PRACTICE GUIDELINES IN THE NHS
Appendix 6. Assessment of macro- and microangiopathy in the diagnose and follow-up of DM 2 Diagnosis CV Risk: BP, CT, TG, HDL, HbA 1 c, Tobacco Initial assessment of macro/microangiopathy Nephropathy: Albumin / creatinine ratio (mg/g) Diabetic foot: Monofi lament, AA Index a , Foot and footwear inspection, symptoms Ocular: OF b CVR c ≥10% after 3-6 months with modification of lifestyle PAS ≥140 PAD ≥80 30-299 Education and assessment of ulcer risk General care Statins Assess aspirin ACE inhibitors or Diuretic Energy multifactorial intervention d Risk Low Increases High e Ulcerate e Control Annual 3-6 months 1-3 months Individual CVR c ≥10% SBP ≥140 30-299 Diabetes evolution DBP ≥80 >15 years Education and assessment of ulcer risk General care Retinopathy No Non-proliferative Proliferative Control 3 years 2 years Individual Follow-up CV Risk: BP, CT, TG, HDL, HbA 1 c, Tobacco Nephropathy: Albumin / creatinine ratio (mg/g) Diabetic foot: Monofi lament, AA Index a , Foot and footwear inspection, symptoms Annual assessment of macro/microangiopathy Ocular: OF b a AA Index (ankle-arm): in case of abnormal physical examination or another macro/microangiopathic disorder. b OF (ocular fundus): non-mydriatic camera or ophthalmologic consultation if there is no camera available. c CVR (cardiovascular risk): estimate according to the REGICOR table. d Diet, exercise, anti-tobacco therapy, ACE-inhibitors, aspirin, therapeutic target: SBP £130 mmHg, intensive HbA 1 c and cholesterol control. e Requires assessment by specialized staff or, if available, foot unit staff or chiropodist. BP, SBP, DBP: blood pressure, systolic blood pressure, diastolic blood pressure; ; OF: ocular fundus; CT: cholesterol; TG: triglycerides. CLINICAL PRACTICE GUIDELINE ON TYPE 2 DIABETES 145
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Clinical Practice Guideline on type
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A bibliographic record of this work
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Table of Contents Presentation 9 Au
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11. Diabetic foot. Assessment, prev
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Presentation Care practice is becom
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Other collaborations Rosa Rico Itur
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13. Which drug combination strategi
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Summary of recommendations Defi nit
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D CPG B B B B A daily single dose
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A B CPG Hypertense patients with DM
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Treatment for diabetic foot ulcers
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1. Introduction Effective care for
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3. Methodology Methodology. Evidenc
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4. Epidemiology and sanitary impact
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However, the quality of the assista
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5.2. Risk factors for the developme
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5.2.8. Diet and alcohol Type of die
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5.2.12. Heart failure The associati
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The ADA does not recommend it for c
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Figure 1. DM 2 diagnostic algorithm
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46 CLINICAL PRACTICE GUIDELINES IN
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6.1. Impaired Fating Glucoseucose (
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1++ An intensive intervention on li
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Different SRs (81-84) have assessed
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7.1.4. Other dietary interventions
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Exchange system This system is base
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duration and intensity). Performing
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[RR 0.75 (CI 95%: 0.60-0.93)], and
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The optimum dose in most patients i
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without heart failure. In this stud
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B B B B Metillinides can play a ro
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Recommendations B A A B B B B When
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8.2. Insulin therapy 8.2.1. Associa
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Slow-acting insulin analogues vs. N
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9. Screening and treatment of macro
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The validity and applicability of a
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The RCTs and the meta-analysis are
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1+ In primary prevention, aspirin b
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9.5.2. Pharmacological treatment of
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Recommendations B/D A B CPG Patient
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incidence was 0.3% after the first
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it is believed that microalbuminuri
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Summary of evidence 1++ In hyperten
Page 96 and 97: An SR on drugs to treat diabetic ne
Page 98 and 99: (241), the response rate to placebo
Page 101 and 102: 11. Diabetic foot. Assessment, prev
Page 103 and 104: 11.2.2. Peripheral arterial disease
Page 105 and 106: 11.4. Other preventive measures The
Page 107 and 108: B D CPG B Diabetic foot screening m
Page 109 and 110: 11.5.4. Antibiotic treatment for in
Page 111: 2+ The culture has a limited value
Page 114 and 115: • Promote healthy lifestyles: die
Page 116 and 117: In another recent RCT (289), sMBG w
Page 118 and 119: 12.3. Contents and methods of an ed
Page 120 and 121: Assessment of self-management recor
Page 122 and 123: 13.4. Referral criteria to medical
Page 125 and 126: Appendices Appendix 1. Levels of Ev
Page 127 and 128: Appendix 2. DM 2 diet Estimating ca
Page 129 and 130: CLINICAL PRACTICE GUIDELINE ON TYPE
Page 141 and 142: GPL-1 Analogues Biguanides Glitazon
Page 143 and 144: Devices FLEXPEN (Novo Nordisk): OPT
Page 145: Treatment for an unconscious patien
Page 149 and 150: Appendix 8. Use of monofilament Mon
Page 157 and 158: Indicators of final outcomes • Nu
Page 159 and 160: Impaired Glucose Tolerance (IGT): I
Page 161 and 162: IGT INSIGHT Trial IV LDL LH LIFE Tr
Page 163 and 164: Bibliography 1. Estrategia en diabe
Page 165 and 166: 33. Iso H, Date C, Wakai K, Fukui M
Page 167 and 168: 64. Screening for type 2 diabetes.
Page 169 and 170: 97. Thomas DE, Elliott EJ, Naughton
Page 171 and 172: 129. Lincoff AM, Wolski K, Nicholls
Page 173 and 174: 157. Natarajan S, Liao Y, Cao G, Li
Page 175 and 176: 185. de GG. Low-dose aspirin and vi
Page 177 and 178: 214. Rahman M, Pressel S, Davis BR,
Page 179 and 180: 245. NZGG. Management of type 2 dia
Page 181 and 182: 279. Norris SL, Nichols PJ, Caspers
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