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Statement by the American Diabetes Association Regarding the American College of Cardiology/American Heart Association Guideline

The goal of this activity is to provide up-to-date information and multiple perspectives on the evolving pathogenesis, symptoms, risk factors, and complications of T2DM as well as current and emerging treatments and best practices in the management of patients with T2DM. All drugs have side effects, but research can also identify new benefits. In addition to these individual risk factors, certain ethnic communities and people from lower socioeconomic groups are particularly at risk. However, IQWiG identified various aspects that could be supplemented and specified. Practice Bulletin 137 on gestational diabetes mellitus provides a rationale for current screening guidelines for a pregnancy population in which prevalence of obesity and Type 2 diabetes has increased over the past several decades. ●In another trial of liraglutide versus placebo in 300 patients (59 percent with type 2 diabetes) with established heart failure and reduced left ventricular ejection fraction who were recently hospitalized, liraglutide had no significant effect on the composite outcome (time to death, time to rehospitalization for heart failure, and time-averaged proportional change in N-terminal pro-B-type natriuretic peptide level) [4]. Both the Association and the ACC/AHA recognize the high prevalence, and morbidity and mortality of cardiovascular disease in patients with diabetes, and the importance of primary and secondary cardiovascular disease risk reduction in this population.

The Association will consider whether moderate-dose statins should be used for the primary prevention in all patients 40-75 years of age with diabetes, regardless of baseline lipid levels or the presence of other cardiovascular risk factors. Notably, the revised 2013 ACC/AHA Cholesterol Treatment Guidelines de-emphasize lipid goal oriented treatment. This program has been planned and implemented in accordance with the ACPE Criteria for Quality and Interpretive Guidelines. The authors propose some mechanisms in the article which are class effects, including the benefits on blood pressure, visceral adiposity, etc. The application of the recommendations in this guideline is not mandatory and the guideline does not override the responsibility of healthcare professionals to make decisions appropriate to the circumstances of the individual patient, in consultation with the patient and/or their carer or guardian.

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