10. Cardiovascular Disease and Risk Management: <i>Standards of Medical Care in Diabetes—2022</i>

Draznin, Boris; Aroda, Vanita R.; Bakris, George L.; Benson, Gretchen; Brown, F. C.; Freeman, RaShaye; Green, Jennifer; Huang, Elbert S.; Isaacs, Diana; Kahan, Scott; León, José; Lyons, Sarah K.; Peters, Anne L.; Prahalad, Priya; Reusch, Jane E.B.; Young-Hyman, Deborah Lee; Das, Sandeep R; Kosiborod, Mikhail

doi:10.2337/dc22-s010

Cited by 347 publications

(245 citation statements)

References 230 publications

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“…In the diabetes care section, a comprehensive approach to reduce complications is recommended. Therapy includes management of glycemia, blood pressure, and lipids and the incorporation of treatment with benefits for CVD and/or CKD outcomes [ 35 ]. Patients with type 2 diabetes and ASCVD are recommended to use SGLT2 inhibitors and/or GLP-1RAs [ 2 , 4 , 10 ].…”

Section: Standards Of Medical Care In Diabetes Of the American Diabet...mentioning

confidence: 99%

Recent Updates to Clinical Practice Guidelines for Diabetes Mellitus

Lee

Kim

2022

Endocrinol Metab

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Guidelines for the management of patients with diabetes have become an important part of clinical practice that improve the quality of care and help establish evidence-based medicine in this field. With rapidly accumulating evidence on various aspects of diabetes care, including landmark clinical trials of treatment agents and newer technologies, timely updates of the guidelines capture the most current state of the field and present a consensus. As a leading academic society, the Korean Diabetes Association publishes practice guidelines biennially and the American Diabetes Association does so annually. In this review, we summarize the key changes suggested in the most recent guidelines. Some of the important updates include treatment algorithms emphasizing comorbid conditions such as atherosclerotic cardiovascular disease, heart failure, and chronic kidney disease in the selection of anti-diabetic agents; wider application of continuous glucose monitoring (CGM), insulin pump technologies and indices derived from CGM such as time in range; more active screening of subjects at high-risk of diabetes; and more detailed individualization in diabetes care. Although there are both similarities and differences among guidelines and some uncertainty remains, these updates provide a good approach for many clinical practitioners who are battling with diabetes.

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Section: Standards Of Medical Care In Diabetes Of the American Diabet...mentioning

confidence: 99%

Recent Updates to Clinical Practice Guidelines for Diabetes Mellitus

Lee

Kim

2022

Endocrinol Metab

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“…The 2021 and 2022 sections devoted to pharmacologic approaches [ 33 , 38 ] report in great detail the pharmacological options for the management of T2DM, but do not mention the use of any supplement or nutraceutical product, either in a positive or negative way. In the section of these “Standards of Medical Care in Diabetes” devoted to cardiovascular disease and risk management [ 39 , 40 ], the authors include, in the 10.15 Recommendation, some dietary suggestions, including “[…] increase of dietary omega-3 fatty acids, viscous fiber, and plant stanols/sterols intake […]” [ 40 ], thus generically mentioning some nutraceuticals discussed in greater detail in the guidelines devoted to the management of dyslipidaemia (see above).…”

Section: Nutraceutical Products and Guidelines For Type 2 Diabetes Me...mentioning

confidence: 99%

Section: Nutraceutical Products and Guidelines For Type 2 Diabetes Me...mentioning

confidence: 99%

Nutraceuticals for Dyslipidaemia and Glucometabolic Diseases: What the Guidelines Tell Us (and Do Not Tell, Yet)

2022

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Background: The use of nutraceutical products and functional foods in the cardiovascular and metabolic field is rising in several countries. Preparation and implementation of guidelines are pivotal for translating research-derived knowledge and evidence-based medicine to the clinical practice. Based on these considerations, the aim of this paper is to explore if and how nutraceutical products are discussed by the most recent international guidelines related to cardio-metabolic diseases (dyslipidaemia, obesity, type 2 diabetes mellitus (T2DM) and cardiovascular disease (CVD) prevention). Some, but not all, guidelines for dyslipidaemia mention nutraceutical products as potential useful options for the treatment of mild dyslipidaemia, but also indicate the low level of evidence associated to their effects on hard endpoints (myocardial infarction, stroke, CVD-related death). In the most recent guidelines on obesity, it is mentioned that no safe and effective dietary supplement nor nutraceutical product is available for the management of weight loss in this condition, and more high-quality studies are necessary in this field. The examined guidelines for T2DM do not mention any specific nutraceutical approach to this disease, nor to milder forms, such as insulin resistance and pre-diabetes. Conclusions: The focus on nutraceutical products in the main international guidelines for cardio-metabolic disease management remains limited. Since robust scientific evidence is the background of useful and effective guidelines, the implementation of high-quality clinical research is strongly needed in the field of nutraceutical products for cardio-metabolic diseases.

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“…The global burden of cardiovascular disease is disproportionately borne by patients with diabetes mellitus (DM) [ 1 – 4 ]. Hyperglycemia, insulin-resistance, and the increased presence of advanced glycation end products (AGEs) represent a handful of the conditions that contribute to a 2 to fourfold increased risk of both coronary and peripheral artery disease (CAD & PVD) in DM [ 5 – 10 ].…”

Section: Introductionmentioning

confidence: 99%

Diabetes and restenosis

Wilson

Mone

Kansakar

et al. 2022

Cardiovasc Diabetol

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Restenosis, defined as the re-narrowing of an arterial lumen after revascularization, represents an increasingly important issue in clinical practice. Indeed, as the number of stent placements has risen to an estimate that exceeds 3 million annually worldwide, revascularization procedures have become much more common. Several investigators have demonstrated that vessels in patients with diabetes mellitus have an increased risk restenosis. Here we present a systematic overview of the effects of diabetes on in-stent restenosis. Current classification and updated epidemiology of restenosis are discussed, alongside the main mechanisms underlying the pathophysiology of this event. Then, we summarize the clinical presentation of restenosis, emphasizing the importance of glycemic control in diabetic patients. Indeed, in diabetic patients who underwent revascularization procedures a proper glycemic control remains imperative.

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10. Cardiovascular Disease and Risk Management: Standards of Medical Care in Diabetes—2022

Cited by 347 publications

References 230 publications

Recent Updates to Clinical Practice Guidelines for Diabetes Mellitus

Recent Updates to Clinical Practice Guidelines for Diabetes Mellitus

Nutraceuticals for Dyslipidaemia and Glucometabolic Diseases: What the Guidelines Tell Us (and Do Not Tell, Yet)

Diabetes and restenosis

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