Evidence-base - International Diabetes Federation

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Anglo‐Scandinavian Cardiac Outcomes Trial‐Blood Pressure Lowering Arm (ASCOT‐BPLA): a multicentre randomised controlled trial. Lancet 2005; 366: 895‐906. 17. Kronish IM, Woodward M, Sergie Z, et al. Meta-analysis: impact of drug class on adherence to antihypertensives. Circulation 2011; 123: 1611- 1621. 10 BLOOD PRESSURE CONTROL 71
Global Guideline for Type 2 <strong>Diabetes</strong> 72 11 CARDIOVASCULAR RISK PROTECTION Cardiovascular risk protection through blood glucose control, blood pressure control, and lifestyle interventions is dealt with elsewhere in this guideline (see Chapter 5: Lifestyle management, Chapter 6: Glucose control levels and Chapter 10: Blood pressure control). This section deals with cardiovascular risk assessment, lipid modifying therapy and anti-platelet therapy. Recommendations Recommended care CV1 Assess cardiovascular risk factors at diagnosis and at least annually thereafter including: • Current or previous CVD. • Age and BMI (abdominal adiposity). • Conventional CVD risk factors including smoking, blood pressure, serum lipids and family history of premature CVD. • Renal damage (particularly albuminuria). • Atrial fibrillation (for stroke). CV2 Assessment of absolute CVD risk is an option for stratifying risk. Use of risk equations developed for people with diabetes is preferred. CV3 People with a previous CVD event should be treated with lifestyle modification, low-dose aspirin (or clopidigrel), statins and blood pressure lowering medications, unless contraindicated or considered clinically inappropriate. CV4 High risk individuals should be actively treated to reduce CVD risk with lifestyle modification and pharmacotherapy. Anti-platelet therapy is not routinely recommended in high risk individuals who have not had a CVD event. CV5 Ensure optimal management through lifestyle measures (see Chapter 5: Lifestyle management), and measures directed at good blood glucose and blood pressure control (see Chapter 6: Glucose control levels and Chapter 10: Blood pressure control). CV6 Arrange smoking cessation advice in smokers contemplative of reducing or stopping tobacco consumption. CV7 Treat high risk individuals with statins unless contraindicated or considered clinically inappropriate. CV8 Consider the addition of fenofibrate where serum triglycerides are > 2.3 mmol/l (> 200 mg/dl) and high density lipoprotein (HDL) cholesterol is low, especially when retinopathy is present. Combination of gemfibrizol with a statin is not recommended.
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INTERNATIONAL DIABETES FEDERATION,
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Correspondence, and related literat
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Global Guideline for Type 2 Diabete
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Methodology The following methodolo
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GLOBAL GUIDELINE FOR TYPE 2 DIABETE
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1 SCREENING AND DIAGNOSIS Recommend
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Evidence-base Diabetes is associate
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Implementation A clear and transpar
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2 CARE DELIVERY Recommendations Rec
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Evidence-base Systems underlying st
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Potential indicator Indicator Denom
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Page 92 and 93: 13 KIDNEY DAMAGE Recommendations Th
Page 94 and 95: Evidence-base CKD is defined as a g
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Evidence-base - International Diabetes Federation

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