Guidelines Diabetes, Pre-Diabetes & Cardiovascular Diseases: The Top Ten Recommendations 

Inspired by the recent Implemention Meeting of the Guidelines on Diabetes, Prediabetes and Cardiovascular Diseases reported on here, discover the Top Ten Recommendations of Task Force chairs Professors Rydén and Standl in terms of Diabetes, Pre-diabetes and Cardiovascular Diseases.

• 1 - Reach (all) treatment targets to reduce cardiovascular risk, including targets on glycaemic control
• 2 - Screen for diabetes and impaired glucose tolerance in all patients with established cardiovascular disease (both acute or chronic) by means of an oral glucose tolerance test, as well as in all high risk individuals, e.g. as defined by risk score tools
• 3 - Life style counselling (150 min physical activity per week, weight loss of 5 to 7 %, smoking cessation) is the cornerstone in the prevention of diabetes mellitus and cardiovascular disease, and the foundation of any multifactorial intervention to reduce cardiovascular risk
• 4 - Whenever possible, patients with diabetes mellitus and acute coronary syndromes should be offered early angiografy and mechanical revascularisation, together with all other standard guideline based treatment recommendations
• 5 - Treatment decisions regarding revascularisation in patients with diabetes should favour coronary artery bypass surgery over percutaneous intervention
• 6 - When percutaneous coronary intervention (PCI) with stent implantation is performed in a diabetic patient, drug-eluting stents should be used
• 7 - Specific risk assessment of patients with diabetes mellitus and cardiovascular disease should include appropriate investigation for cardiac autonomic dysfunction, heart failure, arrhythmias, hypotension, peripheral vascular disease (Doppler-Index), and (micro-)albuminuria
• 8 - Strict blood glucose control with intensive insulin therapy improves mortality and morbidity of adult critically ill patients as well as of adult cardiac surgery patients
• 9 - Multifactorial therapy (lipid normalisation, tight control of hypertension, near-normal glucose control, antiplatelet therapy) is cost-effective in preventing complications in patients with diabetes and cardiovascular disease
• 10 - The joint approach of cardiologists and diabetologists is mandatory for the sake of the millions of patients with diabetes, pre-diabetes and cardiovascular disease in view of the huge overlap between cardiovascular and metabolic diseases, and the first time joint effort of the European Association for the Study of Diabetes (EASD) and the European Society of Cardiology (ESC) is highly appropriate.