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6.2. Impaired Glucose Tolerance (IGT) 48
6.3. Preventive interventions in patients with intermediate hyperglycaemia 48
7. Diet and exercise 51
7.1. Diet 51
7.1.1. Introduction 51
7.1.2. Effectiveness of the interventions to lose weight 51
7.1.3. Composition of fat in the diet 53
7.1.4. Other dietary interventions 54
7.1.5 Diet planning methods 54
7.2. Exercise 57
8. Glycemic control 59
8.1. Glycemic control with oral antidiabetic drugs 59
8.1.1. HbA 1
c targets 59
8.1.2. Initial treatment with monotherapy 61
8.1.3. Combination therapy after inadequate control with initial monotherapy 66
8.1.4. Treatment after two-drug combination therapy failure 68
8.2. Insulin therapy 70
8.2.1. Association of insulin with oral antidiabetic drugs 70
8.2.2. Insulin analogues 70
9. Screening and treatment of macrovascular complications 75
9.1. Cardiovascular risk in diabetic patients 75
9.1.1. Comparison of cardiovascular morbimortality in diabetic patients
and patients who have suffered from a previous acute myocardial
infarction 76
9.1.2. Cardiovascular risk tables 76
9.2. Coronary heart disease screening 77
9.3. Antiplatelett treatment 78
9.4. Treatment with statins 79
9.5. Treatment for high blood pressure 82
9.5.1. Target blood pressure 82
9.5.2. Pharmacological treatment of high blood pressure 83
10. Screening and treatment of microvascular complications 87
10.1. Diabetic retinopathy screening 87
10.2. Diabetic nephropathy 89
10.2.1. Diabetic nephropathy screening 89
10.2.2. Treatment for diabetic microalbuminuria 90
10.3. Diabetic peripheral nephropathy 92
10.4. Erectile dysfunction 95
10.4.1. Phosphodiesterase inhibitors 95
10.4.2. Apomorphine 95
10.4.3. Intracavernosal alprostadil 96
10.4.4. Psychosocial interventions 96
6 CLINICAL PRACTICE GUIDELINES IN THE NHS