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Table 1 Standards of care for the management of diabetes according to the recommendations from the International Diabetes Federation

From: Sex differences in the risk of vascular disease associated with diabetes

Standards of care for the management of diabetes by the International Diabetes Federation [3, 45]

Risk factor screening

Lifestyle and education

Drug interventions and target values

Clinical assessment:

- Weight, BMI, waist circumference, blood pressure, screening for retinopathy (every 1 to 2 years) and peripheral neuropathy, feet exam (every year), screening for macrovascular disease (if patient is symptomatic).

Biochemical assessment:

- HbA1c, lipid spectrum, renal function (every year)

Lifestyle assessment:

- Smoking status, overweight, physical activity, diet

Education:

- Referral to diabetes education program

Diet:

- Reduce caloric intake with obesity or overweight, if possible referral to a dietician

- Prefer high fiber and low-glycemic index foods

- Avoidance of sugar, sweets, and sweetened beverages

Physical activity:

- Increase of physical activity

Habits:

- Avoid smoking

- Avoid excess alcohol intake

Start lipid-lowering drugs:

- T2DM and established CVD

- T2DM, no established CVD, ≥ 40 years and LDL cholesterol > 100 mg/dL

- T2DM, no established CVD, LDL cholesterol > 70 mg/dL may benefit especially with high 10-year CVD risk

Start glucose-lowering drugs:

- General HbA1c target < 7%, > 8% is generally unacceptable

- HbA1c levels between 7.5 and 8% may be acceptable for patients using multiple drugs, if expected survival is limited, cognitive impairment CKD or severe CVD associated with multiple comorbidities.

Start antihypertensive drugs:

- Diastolic target 80 mmHg

- Systolic target of 130 to 140 mmHg

Start ACE-inhibitor or ARB:

- Persistent albuminuria

  1. [3,45] CVD cardiovascular disease, BMI body mass index, T2DM type 2 diabetes mellitus, CKD chronic kidney disease, ACE-I angiotensin converting enzyme-inhibitor, ARB angiotensin receptor blocker