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Two large European organizations – the European Cardiology Society (ESC) in collaboration with the European Association for the Study of Diabetes (EASD) – have released a new guidelines for patients with diabetes or prediabetic diseases related to the use of new drugs and the prevention of cardiovascular disease (CVD). The recommendations were presented at ESC Congress, and were also published in the European Heart Journal.
The guidelines presented in the 2019 show the recent positive results of large studies in cardiovascular morbidity using new drug groups (GLP-1 and SGLT2) against diabetes and other new developments. It also changes the existing approach by which the drug metformin was the only initial treatment for anyone with diabetes previously.
A system for assessing the risks of cardiovascular diseases has been introduced to replace primary and secondary prevention – medium, high and very high.
The authors explain the new approach so that over the past 5 years, impressive documented evidence has been obtained on the efficiency of new drugs – SGLT2 and GLP-1. These drugs are used to treat the type 2 diabetes or non-insulin-dependent diabetes, and significantly reduce the incidence of cardiovascular disease.
Guildelines classify patients with diabetes as follows:
Median Risk of Cardiovascular Disease (CVD)
High CV risk
Very high CV risk
Now, a modern approach for first-line therapy begins with metformin (metformin) + GLP-1 or SGLT2 for patients with type 2 diabetes and a high or very high CV risk.
The recommendations also point to a reduction in cardiovascular risk with GLP-1 is likely due to a decrease in atherosclerosis-related events, while SGLT2 inhibitors reduce the cardiovascular events associated with heart failure.
The document also recommends the use of lipid target to determine the risk of cardiovascular disease (CVD):
Source: Emed, Israel.
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