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Diabetes and heart disease are the most common chronic diseases.
If they are not treated in time, they may cause irreversible damage to the body
.
And when diabetes suffers from heart disease, it will bring a "double blow" to the patient
.
In order to further improve the diagnosis, treatment and management level of diabetes complicated with cardiovascular disease, on June 6, the "Expert Consensus on Diagnosis and Treatment of Diabetic Patients with Cardiovascular Disease" (hereinafter referred to as "Consensus") was officially released in Beijing
.
More than a hundred people including relevant leaders of the Capacity Building and Continuing Education Center of the National Health Commission, expert representatives of the research project team for the interdisciplinary cooperative diagnosis and treatment model of diabetes and cardiovascular disease, relevant heads of the editorial department of the Chinese Journal of Internal Medicine, media representatives and relevant medical personnel attended the event.
, Yimaitong was invited to participate in this conference
.
Interdisciplinary collaboration to build a "heart line of defense" for sugar friends, Tang Jian'an, deputy director of the National Health Commission's Capacity Building and Continuing Education Center, pointed out in his speech: People's health is an important symbol of national prosperity and national prosperity
.
Under the strategic deployment of comprehensively promoting the construction of a healthy China, the center issued the "Expert Consensus on Diagnosis and Treatment of Diabetic Patients with Cardiovascular Disease", which is not only an important measure to implement the Healthy China Initiative, but also an important starting point for improving the service capabilities and management level of health professionals
.
It is hoped that on the new starting point and new journey in 2021, the cooperative teams will continue to stay true to their original aspirations, be steady and far-reaching, and improve both the multidisciplinary management of chronic diseases and the ability of diagnosis and treatment services, and write a new chapter for improving people's health
.
Professor Ma Changsheng, leader of the research project team for the interdisciplinary cooperative diagnosis and treatment model of diabetes and cardiovascular disease, and director of the Cardiology Center of Beijing Anzhen Hospital, Capital Medical University, said: With the development of socio-economic culture, life>
.
He emphasized that this is a consensus to adopt an interdisciplinary cooperation model throughout the whole process.
Experts in the fields of cardiology and endocrinology will participate in, cooperate closely, and fully discuss, respectively, from the perspectives of cardiovascular disease and diabetes management.
Comprehensively refer to the research progress and expert experience of relevant disciplines at home and abroad, and summarize the recommendations suitable for our country
.
Professor Mu Yiming, leader of the research project team for the interdisciplinary cooperative diagnosis and treatment model of diabetic cardiovascular disease and director of the Endocrinology Department of the First Medical Center of the Chinese People’s Liberation Army General Hospital (Beijing 301 Hospital), pointed out that the current prevalence of diabetes in adults over 18 in China is 12.
8%.
The sick population reaches 130 million, and the prevalence is increasing year by year
.
Diabetes and cardiovascular diseases have a "common soil" and similar risk factors.
Popularizing and strengthening the comprehensive management of diabetic patients, improving the prognosis and improving the quality of life are still facing severe challenges
.
It is hoped that through the release of this consensus, more patients will be called on to pay attention to the comprehensive management of the disease and promote more medical staff to understand the standardized and standardized diagnosis and treatment of "sugar control and heart protection"
.
Professor Hou Jianjun, the editor in charge of the consensus and the editorial department of the Chinese Journal of Internal Medicine, said: This consensus invites well-known experts and scholars in interdisciplinary fields.
It took more than a year and was finally issued after repeated discussions
.
The consensus covers important clinical content related to the diagnosis, drug treatment, and risk factor management of diabetes complicated with cardiovascular disease (mainly including atherosclerotic cardiovascular disease and heart failure).
It also targets special populations such as diabetic nephropathy and the elderly (>75 Years old) and critically ill patients with cardiovascular disease gave specific clinical recommendations, aimed at strengthening the comprehensive management of patients and ultimately improving the prognosis of patients
.
Multi-dimensional support, common spectrum of sugar heart management "white paper" Subsequently, the core expert representatives of the interdisciplinary cooperative diagnosis and treatment model research project team for diabetes and cardiovascular diseases interpreted the key content of the consensus
.
Professor Guo Yuanlin from Fuwai Hospital of the Chinese Academy of Medical Sciences first introduced the "Diagnosis and Basic Drug Treatment of Coronary Heart Disease in Diabetic Patients"
.
➤Consensus points out the importance of recognizing typical myocardial ischemia symptoms.
Patients with typical symptoms that can be induced by mild physical activity should be alert to acute coronary syndrome (ACS), and refer to emergency or cardiology specialists for diagnosis and treatment as soon as possible; Symptoms consider more severe coronary stenosis, and further coronary angiography (CAG) or CT angiography (CCTA) is required; ➤In resting state, especially those who are prone to myocardial ischemia in the early morning, they need to consider coronary spastic angina.
And further check to confirm the diagnosis
.
Professor Guo Yuanlin emphasized that asymptomatic myocardial ischemia or even painless myocardial infarction is one of the important reasons that the risk of fatal coronary heart disease in diabetic patients is much higher than that in non-diabetic patients.
Therefore, the risk of coronary heart disease is extremely high (including diabetes with left ventricular ejection).
Diabetes patients with score <50%, ischemic stroke, peripheral arterial stenosis, severe renal insufficiency, familial hypercholesterolemia, coexisting multiple cardiovascular risk factors; type 1 diabetes ≥20 years) should be treated even if they are asymptomatic Regularly screen for coronary heart disease
.
In terms of drug treatment, once patients with diabetes consider coronary heart disease, their basic drug treatment should include antiplatelet therapy, cholesterol-lowering therapy, renin-angiotensin aldosterone system (RAAS) inhibition therapy, and anti-myocardial ischemia therapy.
It is the first three types of drugs that help improve the prognosis of patients
.
Professor Peng Daoquan from the Second Xiangya Hospital of Central South University gave a lecture on "Blood Pressure and Blood Lipid Management and Antithrombotic Strategies for Diabetic Patients"
.
Consensus points out: ➤The blood pressure target for patients with diabetes and cardiovascular disease should be less than 130/80mmHg, and if not tolerated, it can be relaxed to <140/90 mmHg; ➤For patients with diabetes and hypertension, angiotensin-converting enzyme inhibitor is the first choice for antihypertensive drugs (ACEI) or angiotensin II receptor blocker (ARB) drugs; ➤Blood pressure ≥160/100 mmHg, higher than the target blood pressure 20/10mmHg, or those who do not meet the target of single-drug therapy should be combined with antihypertensive therapy
.
In patients with diabetes and coronary heart disease, antihypertensive drugs plus β-blockers
.
The consensus also recommends home blood pressure monitoring (HBPM) and ambulatory blood pressure monitoring (ABPM)
.
In terms of blood lipid management, consensus recommends differentiated management based on ASCVD risk stratification
.
All patients with diabetes should first undergo risk stratification of atherosclerotic cardiovascular disease (ASCVD) and adopt corresponding treatment goals
.
It is recommended that all diabetics adopt a healthy life>
.
If the life>
.
In addition, patients with diabetes aged 40 to 70 years with high/extremely high cardiovascular risk may consider using aspirin for primary prevention when the bleeding risk is low.
However, before antithrombotic therapy, bleeding risk should be assessed and attention should be paid to correct bleeding risk factors
.
Professor Liu Tong from Beijing Anzhen Hospital, Capital Medical University, interpreted the "Choice of Cardiovascular Drugs for Diabetic Nephropathy with Cardiovascular Disease"
.
She pointed out that diabetic nephropathy has become the number one cause of chronic kidney disease (CKD) in China, with a high proportion of heart-kidney-metabolic diseases
.
The new evidence of evidence-based medicine in recent years has provided more optimized drug treatments.
In clinical practice, reasonable choices can be recommended according to the patient's individualized situation and consensus
.
Professor Li Yijun from the First Medical Center of the PLA General Hospital explained blood sugar control, life intervention, and weight management
.
The general principle should be patient-centered, individualized and hierarchical management, and attention should be paid to the balance between the cardiovascular benefits of blood sugar control and the reduction of treatment risks
.
The consensus pointed out that individualized glycosylated hemoglobin (HbA1c) control goals should be determined according to the patient’s age, course of disease, severity of combined cardiovascular disease, and risk of hypoglycemia
.
Pay special attention to preventing hypoglycemia
.
Life>
.
Professor Gu Weijun from the First Medical Center of the General Hospital of the People's Liberation Army focused on the interpretation of "Diabetics and Cardiovascular Disease Patients' Choice of Hypoglycemic Drugs and Combined Treatment Plan"
.
The consensus is based on three groups of people with type 2 diabetes (T2DM) combined with CVD/CKD/special population
.
➤Metformin is recommended as the first-line hypoglycemic drug for patients with T2DM and CVD (no contraindications or intolerance), but it is not recommended for patients with acute and decompensated heart failure
.
➤If there are special circumstances, according to consensus recommendations, reasonable selection of glucagon-like peptide 1 receptor agonist (GLP-1RA), sodium-glucose cotransporter 2 inhibitor (SGLT-2i), dipeptidyl peptidase 4 Inhibitors (DPP-4i) and so on
.
➤In terms of combination therapy, consensus recommends that for T2DM patients with CVD, regardless of baseline HbA1c or individualized HbA1c target value, it is recommended to combine metformin with hypoglycemic drugs with evidence of cardiovascular benefit
.
For patients with ASCVD or heart failure, GLP-1RA or SGLT-2i can be used in combination according to the patient's condition to reduce cardiovascular events
.
Highlights Lianliankan, at the end of the National Health Promotion "Standardization" press conference, Professor Sun Yihong from the China-Japan Friendship Hospital summarized and introduced the highlights of the consensus
.
She once again emphasized that this consensus is a major achievement of the research project of the interdisciplinary cooperative diagnosis and treatment model.
It starts from the perspective of diabetes management and cardiovascular disease management, and learns from each other and complements each other.
It reflects the essence of the research of the two universities of endocrinology and cardiology.
"Finally formulate the best plan to ensure maximum benefit for patients
.
——This will provide important help to improve the diagnosis and treatment of diabetes complicated with cardiovascular disease in China, and also provide experience for the future discussion of broader multidisciplinary cooperation, such as nephrology and neurology
.
The consensus strives to be targeted, evidence-based, and close to the clinic.
It is divided into 18 subsections, comprehensively covering important clinical content related to diabetes and cardiovascular disease diagnosis, drug treatment, and risk factor management
.
Consensus provides reference opinions on the standardization and standardization of diagnosis and treatment of life>
.
In terms of blood glucose control goals, individualized goals of 7%, 7%-8%, and 8%-9% of HbA1c in patients with T2DM and CVD are proposed to achieve hierarchical management
.
The consensus emphasizes individualized treatment and gives feasible solutions
.
For special groups of people, such as elderly (>75 years old), diabetic nephropathy, obesity, cardiovascular critical illness, etc.
patients are analyzed separately, and specific clinical recommendations are given in various aspects such as treatment goals, management approaches, precautions, and risk assessment.
Strive to allow doctors and patients at all levels across the country to receive effective reference, "there is evidence to rely on", and achieve individualized and refined management
.
Participants all expressed that the release of the consensus gave everyone a more comprehensive and clear understanding of diabetes and cardiovascular disease, and a deeper understanding of standardized and standardized diagnosis and treatment
.
At present, many people still have insufficient awareness of the harm of chronic diseases such as diabetes and cardiovascular diseases.
In the future, they hope to promote the health of the whole people through the efforts of both doctors and patients and the whole society in order to achieve the goals of the "Healthy China 2030" Plan.
Make more contributions
.
If they are not treated in time, they may cause irreversible damage to the body
.
And when diabetes suffers from heart disease, it will bring a "double blow" to the patient
.
In order to further improve the diagnosis, treatment and management level of diabetes complicated with cardiovascular disease, on June 6, the "Expert Consensus on Diagnosis and Treatment of Diabetic Patients with Cardiovascular Disease" (hereinafter referred to as "Consensus") was officially released in Beijing
.
More than a hundred people including relevant leaders of the Capacity Building and Continuing Education Center of the National Health Commission, expert representatives of the research project team for the interdisciplinary cooperative diagnosis and treatment model of diabetes and cardiovascular disease, relevant heads of the editorial department of the Chinese Journal of Internal Medicine, media representatives and relevant medical personnel attended the event.
, Yimaitong was invited to participate in this conference
.
Interdisciplinary collaboration to build a "heart line of defense" for sugar friends, Tang Jian'an, deputy director of the National Health Commission's Capacity Building and Continuing Education Center, pointed out in his speech: People's health is an important symbol of national prosperity and national prosperity
.
Under the strategic deployment of comprehensively promoting the construction of a healthy China, the center issued the "Expert Consensus on Diagnosis and Treatment of Diabetic Patients with Cardiovascular Disease", which is not only an important measure to implement the Healthy China Initiative, but also an important starting point for improving the service capabilities and management level of health professionals
.
It is hoped that on the new starting point and new journey in 2021, the cooperative teams will continue to stay true to their original aspirations, be steady and far-reaching, and improve both the multidisciplinary management of chronic diseases and the ability of diagnosis and treatment services, and write a new chapter for improving people's health
.
Professor Ma Changsheng, leader of the research project team for the interdisciplinary cooperative diagnosis and treatment model of diabetes and cardiovascular disease, and director of the Cardiology Center of Beijing Anzhen Hospital, Capital Medical University, said: With the development of socio-economic culture, life>
.
He emphasized that this is a consensus to adopt an interdisciplinary cooperation model throughout the whole process.
Experts in the fields of cardiology and endocrinology will participate in, cooperate closely, and fully discuss, respectively, from the perspectives of cardiovascular disease and diabetes management.
Comprehensively refer to the research progress and expert experience of relevant disciplines at home and abroad, and summarize the recommendations suitable for our country
.
Professor Mu Yiming, leader of the research project team for the interdisciplinary cooperative diagnosis and treatment model of diabetic cardiovascular disease and director of the Endocrinology Department of the First Medical Center of the Chinese People’s Liberation Army General Hospital (Beijing 301 Hospital), pointed out that the current prevalence of diabetes in adults over 18 in China is 12.
8%.
The sick population reaches 130 million, and the prevalence is increasing year by year
.
Diabetes and cardiovascular diseases have a "common soil" and similar risk factors.
Popularizing and strengthening the comprehensive management of diabetic patients, improving the prognosis and improving the quality of life are still facing severe challenges
.
It is hoped that through the release of this consensus, more patients will be called on to pay attention to the comprehensive management of the disease and promote more medical staff to understand the standardized and standardized diagnosis and treatment of "sugar control and heart protection"
.
Professor Hou Jianjun, the editor in charge of the consensus and the editorial department of the Chinese Journal of Internal Medicine, said: This consensus invites well-known experts and scholars in interdisciplinary fields.
It took more than a year and was finally issued after repeated discussions
.
The consensus covers important clinical content related to the diagnosis, drug treatment, and risk factor management of diabetes complicated with cardiovascular disease (mainly including atherosclerotic cardiovascular disease and heart failure).
It also targets special populations such as diabetic nephropathy and the elderly (>75 Years old) and critically ill patients with cardiovascular disease gave specific clinical recommendations, aimed at strengthening the comprehensive management of patients and ultimately improving the prognosis of patients
.
Multi-dimensional support, common spectrum of sugar heart management "white paper" Subsequently, the core expert representatives of the interdisciplinary cooperative diagnosis and treatment model research project team for diabetes and cardiovascular diseases interpreted the key content of the consensus
.
Professor Guo Yuanlin from Fuwai Hospital of the Chinese Academy of Medical Sciences first introduced the "Diagnosis and Basic Drug Treatment of Coronary Heart Disease in Diabetic Patients"
.
➤Consensus points out the importance of recognizing typical myocardial ischemia symptoms.
Patients with typical symptoms that can be induced by mild physical activity should be alert to acute coronary syndrome (ACS), and refer to emergency or cardiology specialists for diagnosis and treatment as soon as possible; Symptoms consider more severe coronary stenosis, and further coronary angiography (CAG) or CT angiography (CCTA) is required; ➤In resting state, especially those who are prone to myocardial ischemia in the early morning, they need to consider coronary spastic angina.
And further check to confirm the diagnosis
.
Professor Guo Yuanlin emphasized that asymptomatic myocardial ischemia or even painless myocardial infarction is one of the important reasons that the risk of fatal coronary heart disease in diabetic patients is much higher than that in non-diabetic patients.
Therefore, the risk of coronary heart disease is extremely high (including diabetes with left ventricular ejection).
Diabetes patients with score <50%, ischemic stroke, peripheral arterial stenosis, severe renal insufficiency, familial hypercholesterolemia, coexisting multiple cardiovascular risk factors; type 1 diabetes ≥20 years) should be treated even if they are asymptomatic Regularly screen for coronary heart disease
.
In terms of drug treatment, once patients with diabetes consider coronary heart disease, their basic drug treatment should include antiplatelet therapy, cholesterol-lowering therapy, renin-angiotensin aldosterone system (RAAS) inhibition therapy, and anti-myocardial ischemia therapy.
It is the first three types of drugs that help improve the prognosis of patients
.
Professor Peng Daoquan from the Second Xiangya Hospital of Central South University gave a lecture on "Blood Pressure and Blood Lipid Management and Antithrombotic Strategies for Diabetic Patients"
.
Consensus points out: ➤The blood pressure target for patients with diabetes and cardiovascular disease should be less than 130/80mmHg, and if not tolerated, it can be relaxed to <140/90 mmHg; ➤For patients with diabetes and hypertension, angiotensin-converting enzyme inhibitor is the first choice for antihypertensive drugs (ACEI) or angiotensin II receptor blocker (ARB) drugs; ➤Blood pressure ≥160/100 mmHg, higher than the target blood pressure 20/10mmHg, or those who do not meet the target of single-drug therapy should be combined with antihypertensive therapy
.
In patients with diabetes and coronary heart disease, antihypertensive drugs plus β-blockers
.
The consensus also recommends home blood pressure monitoring (HBPM) and ambulatory blood pressure monitoring (ABPM)
.
In terms of blood lipid management, consensus recommends differentiated management based on ASCVD risk stratification
.
All patients with diabetes should first undergo risk stratification of atherosclerotic cardiovascular disease (ASCVD) and adopt corresponding treatment goals
.
It is recommended that all diabetics adopt a healthy life>
.
If the life>
.
In addition, patients with diabetes aged 40 to 70 years with high/extremely high cardiovascular risk may consider using aspirin for primary prevention when the bleeding risk is low.
However, before antithrombotic therapy, bleeding risk should be assessed and attention should be paid to correct bleeding risk factors
.
Professor Liu Tong from Beijing Anzhen Hospital, Capital Medical University, interpreted the "Choice of Cardiovascular Drugs for Diabetic Nephropathy with Cardiovascular Disease"
.
She pointed out that diabetic nephropathy has become the number one cause of chronic kidney disease (CKD) in China, with a high proportion of heart-kidney-metabolic diseases
.
The new evidence of evidence-based medicine in recent years has provided more optimized drug treatments.
In clinical practice, reasonable choices can be recommended according to the patient's individualized situation and consensus
.
Professor Li Yijun from the First Medical Center of the PLA General Hospital explained blood sugar control, life intervention, and weight management
.
The general principle should be patient-centered, individualized and hierarchical management, and attention should be paid to the balance between the cardiovascular benefits of blood sugar control and the reduction of treatment risks
.
The consensus pointed out that individualized glycosylated hemoglobin (HbA1c) control goals should be determined according to the patient’s age, course of disease, severity of combined cardiovascular disease, and risk of hypoglycemia
.
Pay special attention to preventing hypoglycemia
.
Life>
.
Professor Gu Weijun from the First Medical Center of the General Hospital of the People's Liberation Army focused on the interpretation of "Diabetics and Cardiovascular Disease Patients' Choice of Hypoglycemic Drugs and Combined Treatment Plan"
.
The consensus is based on three groups of people with type 2 diabetes (T2DM) combined with CVD/CKD/special population
.
➤Metformin is recommended as the first-line hypoglycemic drug for patients with T2DM and CVD (no contraindications or intolerance), but it is not recommended for patients with acute and decompensated heart failure
.
➤If there are special circumstances, according to consensus recommendations, reasonable selection of glucagon-like peptide 1 receptor agonist (GLP-1RA), sodium-glucose cotransporter 2 inhibitor (SGLT-2i), dipeptidyl peptidase 4 Inhibitors (DPP-4i) and so on
.
➤In terms of combination therapy, consensus recommends that for T2DM patients with CVD, regardless of baseline HbA1c or individualized HbA1c target value, it is recommended to combine metformin with hypoglycemic drugs with evidence of cardiovascular benefit
.
For patients with ASCVD or heart failure, GLP-1RA or SGLT-2i can be used in combination according to the patient's condition to reduce cardiovascular events
.
Highlights Lianliankan, at the end of the National Health Promotion "Standardization" press conference, Professor Sun Yihong from the China-Japan Friendship Hospital summarized and introduced the highlights of the consensus
.
She once again emphasized that this consensus is a major achievement of the research project of the interdisciplinary cooperative diagnosis and treatment model.
It starts from the perspective of diabetes management and cardiovascular disease management, and learns from each other and complements each other.
It reflects the essence of the research of the two universities of endocrinology and cardiology.
"Finally formulate the best plan to ensure maximum benefit for patients
.
——This will provide important help to improve the diagnosis and treatment of diabetes complicated with cardiovascular disease in China, and also provide experience for the future discussion of broader multidisciplinary cooperation, such as nephrology and neurology
.
The consensus strives to be targeted, evidence-based, and close to the clinic.
It is divided into 18 subsections, comprehensively covering important clinical content related to diabetes and cardiovascular disease diagnosis, drug treatment, and risk factor management
.
Consensus provides reference opinions on the standardization and standardization of diagnosis and treatment of life>
.
In terms of blood glucose control goals, individualized goals of 7%, 7%-8%, and 8%-9% of HbA1c in patients with T2DM and CVD are proposed to achieve hierarchical management
.
The consensus emphasizes individualized treatment and gives feasible solutions
.
For special groups of people, such as elderly (>75 years old), diabetic nephropathy, obesity, cardiovascular critical illness, etc.
patients are analyzed separately, and specific clinical recommendations are given in various aspects such as treatment goals, management approaches, precautions, and risk assessment.
Strive to allow doctors and patients at all levels across the country to receive effective reference, "there is evidence to rely on", and achieve individualized and refined management
.
Participants all expressed that the release of the consensus gave everyone a more comprehensive and clear understanding of diabetes and cardiovascular disease, and a deeper understanding of standardized and standardized diagnosis and treatment
.
At present, many people still have insufficient awareness of the harm of chronic diseases such as diabetes and cardiovascular diseases.
In the future, they hope to promote the health of the whole people through the efforts of both doctors and patients and the whole society in order to achieve the goals of the "Healthy China 2030" Plan.
Make more contributions
.
