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Health Dictionary

Reliable, easy-to-read patient information on common medical conditions — written in plain language, free of jargon, and grounded in current evidence. Browse the most frequent diagnoses, understand what they mean for everyday life, and learn which steps and questions help you have a focused conversation with your doctor.

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Coronary heart disease secondary prevention diabetes mellitus management

Introduction

2011 AHA/ACCF Guidelines for Secondary Prevention and Risk Reduction Therapy for Patients with Coronary and other Atherosclerotic Vascular Disease (DO NOT EDIT) [1]

2011 AHA/ACCF Guidelines for Secondary Prevention and Risk Reduction Therapy for Patients with Coronary and other Atherosclerotic Vascular Disease (DO NOT EDIT) [1]

Diabetes Mellitus Management (DO NOT EDIT) [1]

Class I
“1. Care for diabetes should be coordinated with the patient’s primary care physician and/or endocrinologist. (Level of Evidence: C)”
“2. Lifestyle modifications including daily physical activity, weight management, blood pressure control, and lipid management are recommended for all patients with diabetes. [2][3][4][5][6][7][8][9][10][11][12][13] (Level of Evidence: B)”
Class IIa

“1. Metformin is an effective first-line pharmacotherapy and can be useful if not contraindicated. [12][14][15] (Level of Evidence: A)”

“2. It is reasonable to individualize the intensity of blood sugar–lowering interventions based on the individual patient’s risk of hypoglycemia during treatment. (Level of Evidence: C)”

Class IIb

“1. Initiation of pharmacotherapy interventions to achieve target HbA1c may be reasonable. [16][17][12][14][15][18][19][20][21] (Level of Evidence: A)”

“2. A target HbA1c of ≤7% may be considered. (Level of Evidence: C)”

“3. Less stringent HbA1c goals may be considered for patients with a history of severe hypoglycemia, limited life expectancy, advanced microvascular or macrovascular complications, or extensive comorbidities, or those in whom the goal is difficult to attain despite intensive therapeutic interventions. (Level of Evidence: C)”

References

References

  1. ↑ 1.0 1.1 Smith SC, Benjamin EJ, Bonow RO, Braun LT, Creager MA, Franklin BA; et al. (2011). “AHA/ACCF Secondary Prevention and Risk Reduction Therapy for Patients with Coronary and other Atherosclerotic Vascular Disease: 2011 update: a guideline from the American Heart Association and American College of Cardiology Foundation”. Circulation. 124 (22): 2458–73. doi:10.1161/CIR.0b013e318235eb4d. PMID 22052934.
  2. ↑ Dattilo AM, Kris-Etherton PM (1992). “Effects of weight reduction on blood lipids and lipoproteins: a meta-analysis”. Am. J. Clin. Nutr. 56 (2): 320–8. PMID 1386186. Unknown parameter |month= ignored (help)
  3. ↑ Schaefer EJ, Lamon-Fava S, Ausman LM; et al. (1997). “Individual variability in lipoprotein cholesterol response to National Cholesterol Education Program Step 2 diets”. Am. J. Clin. Nutr. 65 (3): 823–30. PMID 9062535. Unknown parameter |month= ignored (help)
  4. ↑ Schaefer EJ, Lichtenstein AH, Lamon-Fava S; et al. (1995). “Efficacy of a National Cholesterol Education Program Step 2 diet in normolipidemic and hypercholesterolemic middle-aged and elderly men and women”. Arterioscler. Thromb. Vasc. Biol. 15 (8): 1079–85. PMID 7627699. Unknown parameter |month= ignored (help)
  5. ↑ “Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III) final report”. Circulation. 106 (25): 3143–421. 2002. PMID 12485966. Unknown parameter |month= ignored (help)
  6. ↑ Marwick TH, Hordern MD, Miller T; et al. (2009). “Exercise training for type 2 diabetes mellitus: impact on cardiovascular risk: a scientific statement from the American Heart Association”. Circulation. 119 (25): 3244–62. doi:10.1161/CIRCULATIONAHA.109.192521. PMID 19506108. Unknown parameter |month= ignored (help)
  7. ↑ Haskell WL, Lee IM, Pate RR; et al. (2007). “Physical activity and public health: updated recommendation for adults from the American College of Sports Medicine and the American Heart Association”. Med Sci Sports Exerc. 39 (8): 1423–34. doi:10.1249/mss.0b013e3180616b27. PMID 17762377. Unknown parameter |month= ignored (help)
  8. ↑ Williams MA, Haskell WL, Ades PA; et al. (2007). “Resistance exercise in individuals with and without cardiovascular disease: 2007 update: a scientific statement from the American Heart Association Council on Clinical Cardiology and Council on Nutrition, Physical Activity, and Metabolism”. Circulation. 116 (5): 572–84. doi:10.1161/CIRCULATIONAHA.107.185214. PMID 17638929. Unknown parameter |month= ignored (help)
  9. ↑ Grundy SM, Cleeman JI, Daniels SR; et al. (2005). “Diagnosis and management of the metabolic syndrome: an American Heart Association/National Heart, Lung, and Blood Institute Scientific Statement”. Circulation. 112 (17): 2735–52. doi:10.1161/CIRCULATIONAHA.105.169404. PMID 16157765. Unknown parameter |month= ignored (help)
  10. ↑ Jensen MK, Chiuve SE, Rimm EB; et al. (2008). “Obesity, behavioral lifestyle factors, and risk of acute coronary events”. Circulation. 117 (24): 3062–9. doi:10.1161/CIRCULATIONAHA.107.759951. PMID 18541738. Unknown parameter |month= ignored (help)
  11. ↑ “Standards of medical care in diabetes–2011”. Diabetes Care. 34 Suppl 1: S11–61. 2011. doi:10.2337/dc11-S011. PMC 3006050. PMID 21193625. Unknown parameter |month= ignored (help)
  12. ↑ 12.0 12.1 12.2 Thompson PD, Buchner D, Pina IL; et al. (2003). “Exercise and physical activity in the prevention and treatment of atherosclerotic cardiovascular disease: a statement from the Council on Clinical Cardiology (Subcommittee on Exercise, Rehabilitation, and Prevention) and the Council on Nutrition, Physical Activity, and Metabolism (Subcommittee on Physical Activity)”. Circulation. 107 (24): 3109–16. doi:10.1161/01.CIR.0000075572.40158.77. PMID 12821592. Unknown parameter |month= ignored (help)
  13. ↑ Yu-Poth S, Zhao G, Etherton T, Naglak M, Jonnalagadda S, Kris-Etherton PM (1999). “Effects of the National Cholesterol Education Program’s Step I and Step II dietary intervention programs on cardiovascular disease risk factors: a meta-analysis”. Am. J. Clin. Nutr. 69 (4): 632–46. PMID 10197564. Unknown parameter |month= ignored (help)
  14. ↑ 14.0 14.1 Selvin E, Bolen S, Yeh HC; et al. (2008). “Cardiovascular outcomes in trials of oral diabetes medications: a systematic review”. Arch. Intern. Med. 168 (19): 2070–80. doi:10.1001/archinte.168.19.2070. PMC 2765722. PMID 18955635. Unknown parameter |month= ignored (help)
  15. ↑ 15.0 15.1 “Effect of intensive blood-glucose control with metformin on complications in overweight patients with type 2 diabetes (UKPDS 34). UK Prospective Diabetes Study (UKPDS) Group”. Lancet. 352 (9131): 854–65. 1998. PMID 9742977. Unknown parameter |month= ignored (help)
  16. ↑ Skyler JS, Bergenstal R, Bonow RO; et al. (2009). “Intensive glycemic control and the prevention of cardiovascular events: implications of the ACCORD, ADVANCE, and VA diabetes trials: a position statement of the American Diabetes Association and a scientific statement of the American College of Cardiology Foundation and the American Heart Association”. Circulation. 119 (2): 351–7. doi:10.1161/CIRCULATIONAHA.108.191305. PMID 19095622. Unknown parameter |month= ignored (help)
  17. ↑ Kelly TN, Bazzano LA, Fonseca VA, Thethi TK, Reynolds K, He J (2009). “Systematic review: glucose control and cardiovascular disease in type 2 diabetes”. Ann. Intern. Med. 151 (6): 394–403. PMID 19620144. Unknown parameter |month= ignored (help)
  18. ↑ Turnbull FM, Abraira C, Anderson RJ; et al. (2009). “Intensive glucose control and macrovascular outcomes in type 2 diabetes”. Diabetologia. 52 (11): 2288–98. doi:10.1007/s00125-009-1470-0. PMID 19655124. Unknown parameter |month= ignored (help)
  19. ↑ Ray KK, Seshasai SR, Wijesuriya S; et al. (2009). “Effect of intensive control of glucose on cardiovascular outcomes and death in patients with diabetes mellitus: a meta-analysis of randomised controlled trials”. Lancet. 373 (9677): 1765–72. doi:10.1016/S0140-6736(09)60697-8. PMID 19465231. Unknown parameter |month= ignored (help)
  20. ↑ Currie CJ, Peters JR, Tynan A; et al. (2010). “Survival as a function of HbA(1c) in people with type 2 diabetes: a retrospective cohort study”. Lancet. 375 (9713): 481–9. doi:10.1016/S0140-6736(09)61969-3. PMID 20110121. Unknown parameter |month= ignored (help)
  21. ↑ Holman RR, Paul SK, Bethel MA, Matthews DR, Neil HA (2008). “10-year follow-up of intensive glucose control in type 2 diabetes”. N. Engl. J. Med. 359 (15): 1577–89. doi:10.1056/NEJMoa0806470. PMID 18784090. Unknown parameter |month= ignored (help)


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