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RESEARCH PRODUCT
Translating recent results from the Cardiovascular Outcomes Trials into clinical practice: recommendations from the Central and Eastern European Diabetes Expert Group (CEEDEG)
Kristine DucenaLea DuvnjakTsvetalina TankovaLeszek CzupryniakRoger LehmannGuntram SchernthanerMarina V. ShestakovaPéter KemplerMartin PráznýAndrej JanežAvraham KarasikPeter FaschingEmil Martinkasubject
lcsh:Diseases of the circulatory (Cardiovascular) systemKeywords: Anti-glycaemic drugs ; Cardiovascular disease ; Renal disease ; Type 2 diabetesmedicine.medical_specialtyEndocrinology Diabetes and Metabolism10265 Clinic for Endocrinology and DiabetologyDelphi method610 Medicine & health030209 endocrinology & metabolismReviewType 2 diabetesDisease030204 cardiovascular system & hematologyAnti-glycaemic drugs2705 Cardiology and Cardiovascular MedicineTranslational Research BiomedicalRenal disease03 medical and health sciences0302 clinical medicineMultidisciplinary approachDiabetes mellitusDiabetes MellitusmedicineHumansHypoglycemic AgentsEurope EasternIntensive care medicineExpert TestimonyClinical Trials as Topicbusiness.industryType 2 diabetesCardiovascular diseasemedicine.diseaseExpert groupEuropeEastern european2712 Endocrinology Diabetes and MetabolismTreatment Outcome2724 Internal MedicineCardiovascular Diseaseslcsh:RC666-701Practice Guidelines as TopicCardiology and Cardiovascular MedicinebusinessKidney diseasedescription
Aims These recommendations aim to improve care for patients with type 2 diabetes (T2D) at high cardiovascular (CV) risk in Central and Eastern Europe. Cardiovascular disease (CVD) and/or chronic kidney disease (CKD) are major interdependent comorbidities in patients with T2D, accounting for 50% of mortality. Following recent CV outcomes trial (CVOT) results, including those from EMPA-REG OUTCOME®, LEADER®, SUSTAIN™-6 and, most recently, the CANVAS study, it is essential to develop regional expert consensus recommendations to aid physicians in interpreting these newest data to clinical practice. Methods The Central and Eastern European Diabetes Expert Group (CEEDEG) followed a Delphi method to develop treatment algorithms to aid physicians in the clinical management of patients with T2D at high CV risk. Results In light of the latest CVOT results, and in particular the EMPA-REG OUTCOME® and LEADER® trials, the diagnosis, assessment, treatment choice and monitoring of patients with T2D and established CVD and/or CKD have been considered together with existing guidelines and presented in two reference algorithms. In addition, adherence, special prescribing considerations and a proposed multidisciplinary management approach have been discussed and are presented with the proposed algorithms. Conclusions The latest available high-level evidence on glucose-lowering drugs has enabled CEEDEG to develop practical consensus recommendations for patients with established CVD and/or CKD. These recommendations represent an update to international and country-level guidelines used for these patients, with the aim of providing a resource not only to endocrinologists, but to cardiologists, nephrologists and primary care physicians in the region. Electronic supplementary material The online version of this article (doi:10.1186/s12933-017-0622-7) contains supplementary material, which is available to authorized users.
year | journal | country | edition | language |
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2017-10-23 | Cardiovascular Diabetology |