Diabetes mellitus type 2 secondary prevention: Difference between revisions
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*Treatment of lipid disorder | *Treatment of lipid disorder | ||
:Triglyceride level should be less than 150 mg/dL (1.7 mmol/L) and favorable HDL levels is >40 mg/dL (1.0 mmol/L) for men and >50 mg/dL (1.3 mmol/L) for women. | :Triglyceride level should be less than 150 mg/dL (1.7 mmol/L) and favorable HDL levels is >40 mg/dL (1.0 mmol/L) for men and >50 mg/dL (1.3 mmol/L) for women. | ||
:Statin treatment for preventive measures should be considered for all diabetic patients | :Statin treatment for preventive measures should be considered for all diabetic patients. The following table summarizes the statin therapy strategies: | ||
{| class="wikitable" | |||
!Age | |||
!Risk factors | |||
!Recommended statin dose<sup>†</sup> | |||
|- | |||
|<40 years | |||
|None | |||
CVD risk factor(s)<sup>¶</sup> | |||
Overt CVD<sup>Δ</sup> | |||
|None | |||
Moderate or high | |||
High | |||
|- | |||
|40 to 75 years | |||
|None | |||
CVD risk factors | |||
Overt CVD | |||
|Moderate | |||
High | |||
High | |||
|- | |||
|>75 years | |||
|None | |||
CVD risk factors | |||
Overt CVD | |||
|Moderate | |||
Moderate or high | |||
High | |||
|} | |||
<sup>† :</sup>In addition to lifestyle therapy. | |||
¶ :CVD risk factors include LDL cholesterol ≥100 mg/dL (2.6 mmol/L), high blood pressure, smoking, and overweight and obesity. | |||
Δ :Overt CVD includes those with previous cardiovascular events or acute coronary syndromes. | |||
*Blood pressure control | *Blood pressure control | ||
:Blood pressure should be measured in every visits. Goal of blood pressure is less than 140/90 | :Blood pressure should be measured in every visits. Goal of blood pressure is less than 140/90 |
Revision as of 18:28, 17 March 2017
Diabetes mellitus type 2 Microchapters |
Differentiating Diabetes Mellitus Type 2 from other Diseases |
Diagnosis |
Treatment |
Medical therapy |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Seyedmahdi Pahlavani, M.D. [2]
Overview
Secondary Prevention
Secondary prevention is focused to decrease the macrovascular complications. Application of effective strategies can result in up to 50% risk reduction in macrovascular complications.[1] Effective measures in this case include:[2]
- Glycemic control
- Treatment of lipid disorder
- Triglyceride level should be less than 150 mg/dL (1.7 mmol/L) and favorable HDL levels is >40 mg/dL (1.0 mmol/L) for men and >50 mg/dL (1.3 mmol/L) for women.
- Statin treatment for preventive measures should be considered for all diabetic patients. The following table summarizes the statin therapy strategies:
Age | Risk factors | Recommended statin dose† |
---|---|---|
<40 years | None
CVD risk factor(s)¶ Overt CVDΔ |
None
Moderate or high High |
40 to 75 years | None
CVD risk factors Overt CVD |
Moderate
High High |
>75 years | None
CVD risk factors Overt CVD |
Moderate
Moderate or high High |
† :In addition to lifestyle therapy.
¶ :CVD risk factors include LDL cholesterol ≥100 mg/dL (2.6 mmol/L), high blood pressure, smoking, and overweight and obesity.
Δ :Overt CVD includes those with previous cardiovascular events or acute coronary syndromes.
- Blood pressure control
- Blood pressure should be measured in every visits. Goal of blood pressure is less than 140/90
- Smoking cessation
- Using Aspirin
- Weight reduction
- Vaccination including, annual influenza, pneumococcal vaccination and hepatitis B.
- Regular dental care
- Regular foot care
References
- ↑ Gaede P, Vedel P, Larsen N, Jensen GV, Parving HH, Pedersen O (2003). "Multifactorial intervention and cardiovascular disease in patients with type 2 diabetes". N. Engl. J. Med. 348 (5): 383–93. doi:10.1056/NEJMoa021778. PMID 12556541.
- ↑ Saydah SH, Fradkin J, Cowie CC (2004). "Poor control of risk factors for vascular disease among adults with previously diagnosed diabetes". JAMA. 291 (3): 335–42. doi:10.1001/jama.291.3.335. PMID 14734596.