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 |