2021 ESC Guidelines on cardiovascular disease prevention in clinical practice

European Heart Journal, Journal Year: 2021, Volume and Issue: 42(34), P. 3227 - 3337

Published: Aug. 30, 2021

The ESC Guidelines represent the views of and were produced after careful consideration scientific medical knowledge evidence available at time their publication.The is not responsible in event any contradiction, discrepancy and/or ambiguity between other official recommendations or guidelines issued by relevant public health authorities, particular relation to good use healthcare therapeutic strategies.Health professionals are encouraged take fully into account when exercising clinical judgment, as well determination implementation preventive, diagnostic strategies; however, do override, way whatsoever, individual responsibility make appropriate accurate decisions each patient's condition consultation with that patient and, where necessary, caregiver.Nor exempt from taking full updated competent order manage case light scientifically accepted data pursuant respective ethical professional obligations.It also professional's verify applicable rules regulations relating drugs devices prescription.

Language: Английский

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Management of Hyperglycemia in Type 2 Diabetes, 2018. A Consensus Report by the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD)

Diabetes Care, Journal Year: 2018, Volume and Issue: 41(12), P. 2669 - 2701

Published: Oct. 5, 2018

The American Diabetes Association and the European for Study of convened a panel to update prior position statements, published in 2012 2015, on management type 2 diabetes adults. A systematic evaluation literature since 2014 informed new recommendations. These include additional focus lifestyle self-management education support. For those with obesity, efforts targeting weight loss, including lifestyle, medication, surgical interventions, are recommended. With regards medication management, patients clinical cardiovascular disease, sodium-glucose cotransporter (SGLT2) inhibitor or glucagon-like peptide 1 (GLP-1) receptor agonist proven benefit is chronic kidney disease heart failure atherosclerotic an SGLT2 GLP-1 agonists generally recommended as first injectable medication.

Language: Английский

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Management of Hyperglycemia in Type 2 Diabetes, 2022. A Consensus Report by the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD)

Diabetes Care, Journal Year: 2022, Volume and Issue: 45(11), P. 2753 - 2786

Published: Sept. 23, 2022

The American Diabetes Association and the European for Study of convened a panel to update previous consensus statements on management hyperglycemia in type 2 diabetes adults, published since 2006 last updated 2019. target audience is full spectrum professional health care team providing U.S. Europe. A systematic examination publications 2018 informed new recommendations. These include additional focus social determinants health, system, physical activity behaviors, including sleep. There greater emphasis weight as part holistic approach management. results cardiovascular kidney outcomes trials involving sodium–glucose cotransporter inhibitors glucagon-like peptide 1 receptor agonists, assessment subgroups, inform broader recommendations cardiorenal protection people with at high risk disease. After summary listing recommendations, practical tips implementation are provided.

Language: Английский

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2019 Update to: Management of Hyperglycemia in Type 2 Diabetes, 2018. A Consensus Report by the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD)

Diabetes Care, Journal Year: 2019, Volume and Issue: 43(2), P. 487 - 493

Published: Dec. 19, 2019

The American Diabetes Association and the European for Study of have briefly updated their 2018 recommendations on management hyperglycemia, based important research findings from large cardiovascular outcomes trials published in 2019. Important changes include: 1) decision to treat high-risk individuals with a glucagon-like peptide 1 (GLP-1) receptor agonist or sodium–glucose cotransporter 2 (SGLT2) inhibitor reduce major adverse events (MACE), hospitalization heart failure (hHF), death, chronic kidney disease (CKD) progression should be considered independently baseline HbA1c individualized target; 2) GLP-1 agonists can also patients type diabetes without established (CVD) but presence specific indicators high risk; 3) SGLT2 inhibitors are recommended failure, particularly those reduced ejection fraction, hHF, MACE, CVD as well CKD (estimated glomerular filtration rate 30 ≤60 mL min–1 [1.73 m]–2 urinary albumin-to-creatinine ratio >30 mg/g, >300 mg/g) prevent CKD, death.

Language: Английский

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GLP-1 receptor agonists in the treatment of type 2 diabetes – state-of-the-art

Molecular Metabolism, Journal Year: 2020, Volume and Issue: 46, P. 101102 - 101102

Published: Oct. 14, 2020

GLP-1 receptor agonists (GLP-1 RAs) with exenatide b.i.d. first approved to treat type 2 diabetes in 2005 have been further developed yield effective compounds/preparations that overcome the original problem of rapid elimination (short half-life), initially necessitating short intervals between injections (twice daily for b.i.d.). To summarize current knowledge about agonist. At present, RAs are injected twice (exenatide b.i.d.), once (lixisenatide and liraglutide), or weekly weekly, dulaglutide, albiglutide, semaglutide). A oral preparation semaglutide, which has demonstrated clinical effectiveness close once-weekly subcutaneous preparation, was recently approved. All share common mechanisms action: augmentation hyperglycemia-induced insulin secretion, suppression glucagon secretion at hyper- euglycemia, deceleration gastric emptying preventing large post-meal glycemic increments, a reduction calorie intake body weight. Short-acting agents b.i.d., lixisenatide) reduced on overnight fasting plasma glucose, but maintain their effect during long-term treatment. Long-acting (liraglutide, exenatide, semaglutide) more profound effects glucose HbA1c, both background glucose-lowering combination basal insulin. Effects decrease over time (tachyphylaxis). Given similar, if not superior, HbA1c additional weight no intrinsic risk hypoglycemic episodes, GLP-1RAs recommended as preferred injectable therapy diabetes, even before However, can be combined (basal) either free- fixed-dose preparations. More agents, particular characterized by greater efficacy respect lowering well Since 2016, several cardiovascular (CV) outcome studies shown effectively prevent CV events such acute myocardial infarction stroke associated mortality. Therefore, guidelines particularly recommend treatment patients pre-existing atherosclerotic vascular disease (for example, previous events). The evidence similar lower-risk subjects is quite strong. sodium/glucose cotransporter-2 (SGLT-2) inhibitor reduces (with mainly driven heart failure complications), individual ischemic complications should guide choice may also help renal diabetes. Other active research areas field definition subgroups within population who benefit from RAs. These include pharmacogenomic approaches characterization non-responders. Novel indications outside 1 neurodegenerative diseases, psoriasis, being explored. Thus, 15 years initial introduction, become well-established class potential development growing impact treating potentially other diseases.

Language: Английский

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KDIGO 2020 Clinical Practice Guideline for Diabetes Management in Chronic Kidney Disease

Kidney International, Journal Year: 2020, Volume and Issue: 98(4), P. S1 - S115

Published: Sept. 30, 2020

The Kidney Disease: Improving Global Outcomes (KDIGO) 2020 Clinical Practice Guideline for Diabetes Management in Chronic Disease (CKD) represents the first KDIGO guideline on this subject. scope includes topics such as comprehensive care, glycemic monitoring and targets, lifestyle antihyperglycemic interventions, approaches to self-management optimal models of care. goal is generate a useful resource clinicians patients by providing actionable recommendations with infographics based rigorous, formal systematic literature review. Another aim propose research areas which there are gaps knowledge. targets broad audience treating diabetes CKD while taking into account implications policy payment. development followed an explicit process evidence review appraisal. Treatment reviews relevant studies, appraisal quality evidence, strength following Grading Recommendations Assessment, Development, Evaluation (GRADE) approach. Limitations discussed future presented.

Language: Английский

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Association of SGLT2 Inhibitors With Cardiovascular and Kidney Outcomes in Patients With Type 2 Diabetes

JAMA Cardiology, Journal Year: 2020, Volume and Issue: 6(2), P. 148 - 148

Published: Oct. 7, 2020

Sodium-glucose cotransporter 2 (SGLT2) inhibitors favorably affect cardiovascular (CV) and kidney outcomes; however, the consistency of outcomes across class remains uncertain.

Language: Английский

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Chronic kidney disease

The Lancet, Journal Year: 2021, Volume and Issue: 398(10302), P. 786 - 802

Published: June 24, 2021

Language: Английский

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Semaglutide 2·4 mg once a week in adults with overweight or obesity, and type 2 diabetes (STEP 2): a randomised, double-blind, double-dummy, placebo-controlled, phase 3 trial

The Lancet, Journal Year: 2021, Volume and Issue: 397(10278), P. 971 - 984

Published: March 1, 2021

Language: Английский

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Durability of a primary care-led weight-management intervention for remission of type 2 diabetes: 2-year results of the DiRECT open-label, cluster-randomised trial

The Lancet Diabetes & Endocrinology, Journal Year: 2019, Volume and Issue: 7(5), P. 344 - 355

Published: March 6, 2019

Language: Английский

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