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© 2007 The European Society of Cardiology and European Association for the Study of Diabetes (EASD). All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org
Guidelines on diabetes, pre-diabetes, and cardiovascular diseases: executive summary,
The Task Force on Diabetes and Cardiovascular Diseases of the European Society of Cardiology (ESC) and of the European Association for the Study of Diabetes (EASD)
Authors/Task Force Members,
gorzata Bartnik
Sweden
Germany
Poland
Belgium
UK
The Netherlands
Italy
Sweden
Finland
Sweden
Italy
Sweden
Finland
Iceland
Other Contributors,
Belgium
Italy
Sweden
Finland
ESC Committee for Practice Guidelines (CPG),
Italy
France
Poland
UK
France
The Netherlands
Norway
Greece
France
Italy
Portugal
Germany
Spain
Spain
Document Reviewers,
The Netherlands
France
France
Germany
Italy
Denmark
Germany
Spain
Ireland
Portugal
Germany
Finland
Israel
Austria
Italy
UK
* Corresponding author. Lars Rydén, Department of Cardiology, Karolinska University Hospital Solna, SE-171 76 Stockholm, Sweden. Tel: +49 89 3068 2523; Fax: +49 89 3068 3906. Eberhard Standl, Department of Endocrinology, Munich Schwabing Hospital, D-80804 Munich, Germany. Tel: +49 89 3068 2523; Fax: +49 89 3068 3906. E-mail address: lars.ryden@ki.se; eberhard.standl@lrz.uni_muenchen.de
| The first 150 words of the full text of this article appear below. |
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Preamble |
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Guidelines and Expert Consensus documents aim to present management and recommendations based on all of the relevant evidence on a particular subject in order to help physicians to select the best possible management strategies for the individual patient, suffering from a specific condition, taking into account not only the impact on outcome, but also the risk benefit ratio of a particular diagnostic or therapeutic procedure. The ESC recommendations for guidelines production can be found on the ESC website
.
In brief, the ESC appoints experts in the field to carry out a comprehensive and critical evaluation of the use of diagnostic and therapeutic procedures and to assess the risk–benefit ratio of the therapies recommended for management and/or prevention of a given condition. The strength of evidence for or against particular procedures or treatments is weighed according to predefined scales for grading recommendations and levels of evidence, as outlined below. Once
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Introduction |
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Definition, classification, and screening of diabetes and pre-diabetic glucose abnormalities |
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Definition and classification of diabetes
Glycated haemoglobin
Markers of glucometabolic perturbations
Comparisons between FPG and 2 h post-load glucose
Screening for undiagnosed diabetes
Detection of people at high risk for diabetes
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Epidemiology of diabetes, IGH, and cardiovascular risk |
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Prevalence of disease categories and age
Plasma glucose age and gender
Prevalence of diabetes and IGH
Diabetes and coronary artery disease
IGH and CAD
Cardiovascular risk and post-prandial hyperglycaemia
Glycaemic control and cardiovascular risk
Gender difference in CAD related to diabetes
Glucose homeostasis and cerebrovascular disease
Diabetes and stroke
IGT and stroke
Prevention of CVD in people with IGH
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Identification of subjects at high risk for CVD or diabetes |
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Metabolic syndrome
Definitions
Risk charts
Preventing progression to diabetes
Prevention of CVD by physical activity
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Treatment to reduce cardiovascular risk |
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Lifestyle and comprehensive management
Glycaemic control
Relation to microangiopathy and neuropathy
Relation to macroangiopathy
Relationship with acute coronary syndromes
Current treatment approach to glycaemic control
Dyslipidaemia
Background and epidemiology
Dyslipidaemia and vascular risk
Treatment benefits of statin therapy
Secondary prevention
Goals of therapy for secondary prevention
Primary prevention
Goals of therapy for primary prevention
Fibrate trials
Guidelines for HDL cholesterol and triglycerides
Blood pressure
Background
Treatment targets
How should blood pressure be lowered?
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Management of CVD |
|---|
Coronary artery disease
Epidemiology
Diabetes and ACS
Prognostic implications
Treatment principles
Risk stratification
Treatment targets
Specific treatment
Thrombolysis
Early revascularization
Anti-ischaemic medication
Beta-blockade
Other drugs
Anti-platelet and anti-thrombotic agents
ACE-inhibitors
Lipid-lowering drugs
Metabolic support and control
Diabetes and coronary revascularization
Surgery vs. percutaneous intervention
Adjunctive therapy
Revascularization and reperfusion in MI
Unresolved issues
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Heart failure and diabetes |
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Epidemiological aspects
Prevalence of heart failure and glucose abnormalities
Incidence of heart failure and glucose abnormalities
Prognostic implications
Treatment
ACE-inhibitors
Angiotensin-II receptor blockers
Beta-blockers
Diuretics
Aldosterone antagonists
Glucose-lowering treatment and metabolic modulation
Insulin
Thiazolidinediones
Metabolic modulators
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Arrhythmias: atrial fibrillation and sudden cardiac death |
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Diabetes, atrial fibrillation, and risk of stroke
Diabetes and atrial fibrillation
Diabetes and risk of stroke in atrial fibrillation
Antithrombotic therapy in atrial fibrillation
Diabetes and stroke risk stratification schemes
Antithrombotic therapy in diabetic patients
Sudden cardiac death
Epidemiology of sudden cardiac death in diabetes
Pathophysiology of sudden cardiac death in diabetes
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Peripheral and cerebrovascular disease |
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Peripheral vascular disease
Background
Diagnosis
Treatment
General measures and platelet inhibition
Revascularization
Medical treatment of critical limb ischaemia
Stroke
Background
Prevention of stroke
Treatment of acute stroke
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Intensive care |
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Hyperglycaemia and outcome of critical illness
Blood glucose control with intensive insulin therapy in critical illness
Mechanisms behind improved outcome with intensive insulin
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Health economics and diabetes |
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Cost-of-illness studies
The cost of complications
Cost-effectiveness of intervention
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