Scope of the Problem. Atherosclerotic cardiovascular disease (ASCVD) is the leading cause of death among patients with diabetes. Therefore, managing ASCVD risk is crucial in preventing the progression of atherosclerosis and… Continue reading Diabetes & Cardiovascular Disease
ADA
Hypertension and Diabetes
This concise summary outlines the 2020 American Diabetes Association guidelines on managing hypertension in patients with diabetes. The guidelines cover various aspects such as lifestyle modifications, medications, potential side effects… Continue reading Hypertension and Diabetes
Medications for Type 2 Diabetes
The 2020 American Diabetes Association (ADA) guidelines recommend the following medications for type 2 diabetes (DM2): It is important to note that the drug recommendations provided above are general and… Continue reading Medications for Type 2 Diabetes
Key Revisions of 2020 ADA guidelines
Here you can find the critical modifications in 2020 ADA guidelines. Particular emphasis is placed on pharmacological therapy with GLP-1 agonists or SGLT-2 inhibitors for patients with established cardiovascular disease, heart failure, or chronic kidney disease. Guidelines are published yearly in the month of January.
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2019 ADA guidelines: Key Revisions
You can find here key changes in ADA guidelines. They are published in Diabetes Care once yearly in the month of January. Specific topics will be further discussed and posted here. Stay tuned!
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Review of 2018 ADA guidelines: dyslipidemia in the context of diabetes
ADA recommendations are released each January. Below is a succinct ACP review of guidelines in screening, treatment goals, lifestyle intervention, and drug approach to dyslipidemia in the setting of diabetes mellitus. LDL-cholesterol is still a main target. Charts depict indications and doses of statins, the mainstay therapy to diabetic lipid disorders.
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Review of 2018 ADA Guidelines: hypertension in the context of diabetes
ADA standards are released each January. Here is a succinct ACP review of guidelines in screening, diagnosis, treatment goals, lifestyle intervention, and drug approach to hypertension in the setting of diabetes mellitus. The chart depicts nicely the flow process of how to initiate and intensify the pharmacological therapy.
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2017 ADA guidelines: dyslipidemia and diabetes
Below you can find ADA recommendations on screening, cardiovascular risks, and treatment of dyslipidemia in the context of diabetes. As always improve lifestyle choices first. If ASCVD likelihood is still high then add medications. Statins are first-line, either of moderate or high intensity. Statin selection would depend on age, CVD status, and contributing factors.
Statin plus PCSK9 inhibitor or statin plus zetia could be used in adults with residual ASCVD risk. Statin plus fenofibrate is no longer advised unless special circumstances are present; severe hypertriglyceridemia or in men with profound metabolic syndrome. Statin plus niacin is also not recommended due to stroke concerns.
For more details, ADA standards are listed below with a slightly modified wording for easier and succinct reading:
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2017 ADA guidelines: diabetes during pregnancy
Below you can find ADA standards on proper A1c targets, blood pressure range, retinopathy monitoring and medications used in preexisting and gestational diabetes. The preferred medications during pregnancy are insulin, metformin and glyburide.
Recommendations are listed below with slightly modified wording for easier and succinct reading:
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2017 ADA guidelines: metabolic surgery for type 2 diabetes
Obesity is a pro-inflammatory state contributing to insulin resistance and type 2 diabetes. Starting with jejuno-ileal bypass in 1954 by Kremer and intestinal bypass in 1967 by Mason, various techniques of the malabsorption surgery have been developed, researched and applied over the decades. They have shown good results in reducing hyperglycemia, the number of diabetic medications and excessive body weight.
Guidance on the importance and indications of metabolic surgery for type 2 diabetes were published in Diabetes Care, January 2017. Recommendations are listed below with a slightly modified wording for easier and succinct reading:
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2017 ADA position statement: hypertension in diabetes
High blood pressure is common in patients with diabetes. Both hypertension and diabetes are independent risk factors for poor cardiovascular outcomes. Obviously the concomitant presence of both HTN and DM in an individual magnifies the chance for CVD events. It is important to screen, diagnose and treat high blood pressure appropriately in someone with diabetes, particularly type 2.
ADA published a position statement on the subject in Diabetes Care, September 2017. The article is comprehensive in regard to proper diagnosis, clinic vs. home BP measurements, target blood pressure values, life style modifications, pharmacological agent initiation and titration, and barriers to therapy. Recommendations are listed below with slightly modified wording for easier and succinct reading:
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2017 ADA Guidelines: Glucose Targets
Last ADA standards were published in January 2017. You could find below the recommended glucose aims for patients with type 1 and type 2 diabetes. Guidelines offer flexibility on A1c targets from <6.5-8.0% depending on person’s age, life expectancy, polypharmacy, disease duration, hypoglycemia frequency and comorbidities.
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