Diabetes mellitus type 2 secondary prevention: Difference between revisions
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: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. The following table summarizes the statin therapy strategies: | :Statin treatment for preventive measures should be considered for all diabetic patients. The following table summarizes the statin therapy strategies: | ||
{| | <span style="font-size:85%">'''Abbreviations:''' | ||
!Age | '''CVD:''' Cardiovascular disease | ||
!Risk factors | </span> | ||
!Recommended statin dose<sup>†</sup> | <br> | ||
{| style="border: 0px; font-size: 90%; margin: 3px;" align=center | |||
!align="center" style="background:#DCDCDC;"|Age | |||
!align="center" style="background:#DCDCDC;"|Risk factors | |||
!align="center" style="background:#DCDCDC;"|Recommended statin dose<sup>†</sup> | |||
|- | |- | ||
|<40 years | |style="padding: 5px 5px; background: #F5F5F5;" align="left" |<40 years | ||
|None | |style="padding: 5px 5px; background: #F5F5F5;" align="left" |None | ||
CVD risk factor(s)<sup>¶</sup> | CVD risk factor(s)<sup>¶</sup> | ||
Overt CVD<sup>Δ</sup> | Overt CVD<sup>Δ</sup> | ||
|None | |style="padding: 5px 5px; background: #F5F5F5;" align="left" |None | ||
Moderate or high | Moderate or high | ||
High | High | ||
|- | |- | ||
|40 to 75 years | |style="padding: 5px 5px; background: #F5F5F5;" align="left" |40 to 75 years | ||
|None | |style="padding: 5px 5px; background: #F5F5F5;" align="left" |None | ||
CVD risk factors | CVD risk factors | ||
Overt CVD | Overt CVD | ||
|Moderate | |style="padding: 5px 5px; background: #F5F5F5;" align="left" |Moderate | ||
High | High | ||
High | High | ||
|- | |- | ||
|>75 years | |style="padding: 5px 5px; background: #F5F5F5;" align="left" |>75 years | ||
|None | |style="padding: 5px 5px; background: #F5F5F5;" align="left" |None | ||
CVD risk factors | CVD risk factors | ||
Overt CVD | Overt CVD | ||
|Moderate | |style="padding: 5px 5px; background: #F5F5F5;" align="left" |Moderate | ||
Moderate or high | Moderate or high | ||
Revision as of 18:36, 17 March 2017
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Diabetes mellitus type 2 Microchapters |
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Differentiating Diabetes Mellitus Type 2 from other Diseases |
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Diagnosis |
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Treatment |
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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:
Abbreviations:
CVD: Cardiovascular disease
| 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.