ESC Guidelines on diabetes, prediabetes, and cardiovascular diseases developed in collaboration with EASD: Summary of the document prepared by the Czech Society of Cardiology
Abstract
This is the second iteration of the European Society of Cardiology (ESC) and European Association for the Study of Diabetes (EASD) joining forces to write guidelines on the management of the combination of diabetes mellitus (DM), pre-diabetes, and cardiovascular disease (CVD), designed to assist clinicians and other healthcare workers to make evidence based management decisions. More than half the mortality and a vast amount of morbidity in people with DM are related to CVD, which caused physicians in the fields of DM and cardiovascular medicine to join forces to research and manage these conditions.
Healthy eating, regular physical activity and cessation of smoking are first measures for the prevention and/or management of T2DM and other attending risk factors (hypertension, dyslipidemia, etc.) with targets of weight loss and reduction of CV risk. Patients with a short duration of T2DM and without a history of CVD, without trend to hypoglycaemia seemed to benefit from more-intensive glucose-lowering strategies (HbA1c 42-48 mmol/mol) for reducing long-term macrovascular complications.
An HbA1c target of <53 mmol/mol to reduce microvascular disease is a generally accepted level. The choice of agent, the conditions of their use and the role of combination therapy have been extensively reviewed in the joint ADA/EASD guidelines.