Diabetes mellitus type 2 secondary prevention
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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
The most important aspect of secondary prevention in diabetes mellitus type 2 is to decrease the mortality from macrovascular complications. Among the preventive measures, lipid control, smoking cessation and the treatment of hypertension are the most important ones.
Secondary Prevention
Secondary prevention is focused on decreasing 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 on 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.