Diabetes Diagnosis and Cardiovascular Risk Assessment

Diagnosis of Diabetes

• Screening for diabetes is recommended in all individuals with CVD, using fasting glucose and/or HbA1c.
• Diagnosis of diabetes should be based on HbA1c and/or fasting plasma glucose, or on an OGTT if still in doubt.

Assessing Cardiovascular Risk in Patients with Diabetes

• Patients with diabetes should be screened for the presence of severe TOD.
• Medical history and symptoms suggestive of ASCVD should be assessed in patients with diabetes.
• In patients with T2DM without symptomatic ASCVD or severe TOD, 10-year CVD risk should be estimated via SCORE2-Diabetes.

Weight Reduction in Patients with Diabetes

• Individuals with diabetes and overweight or obesity should aim to reduce weight and increase physical exercise to improve metabolic control and overall CVD risk profile.

Nutrition in Patients with Diabetes

• Adopting a Mediterranean or plant-based diet with high unsaturated fat content is recommended to lower cardiovascular risk.

Physical Activity/Exercise in Patients with Diabetes

• Increasing physical activity (e.g., 10 min daily walking) is recommended in all patients with T2DM with and without CVD.
• Optimal physical activity is a weekly activity of 150 min of moderate intensity or 75 min of vigorous endurance intensity.
• Exercise interventions should be adapted to T2DM-associated comorbidities, e.g., frailty, neuropathy, or retinopathy.
• Structured exercise training is recommended in patients with T2DM and established CVD to improve metabolic control, exercise capacity, and quality of life, and to reduce CV events.
• Resistance exercise should be performed in addition to endurance exercise at least twice a week.

Smoking Cessation in Patients with Diabetes

• Smoking cessation is recommended to reduce cardiovascular risk.

Glycaemic Targets

• Tight glycaemic control (HbA1c < 7%) is recommended.

Diagnosis of Diabetes

• Screening for diabetes is recommended in all individuals with CVD, using fasting glucose and/or HbA1c.
• Diagnosis of diabetes should be based on HbA1c and/or fasting plasma glucose, or on an OGTT if still in doubt.

Assessing Cardiovascular Risk in Patients with Diabetes

• Patients with diabetes should be screened for the presence of severe TOD.
• Medical history and symptoms suggestive of ASCVD should be assessed in patients with diabetes.
• In patients with T2DM without symptomatic ASCVD or severe TOD, 10-year CVD risk should be estimated via SCORE2-Diabetes.

Weight Reduction in Patients with Diabetes

• Individuals with diabetes and overweight or obesity should aim to reduce weight and increase physical exercise to improve metabolic control and overall CVD risk profile.

Nutrition in Patients with Diabetes

• Adopting a Mediterranean or plant-based diet with high unsaturated fat content is recommended to lower cardiovascular risk.

Physical Activity/Exercise in Patients with Diabetes

• Increasing physical activity (e.g., 10 min daily walking) is recommended in all patients with T2DM with and without CVD.
• Optimal physical activity is a weekly activity of 150 min of moderate intensity or 75 min of vigorous endurance intensity.
• Exercise interventions should be adapted to T2DM-associated comorbidities, e.g., frailty, neuropathy, or retinopathy.
• Structured exercise training is recommended in patients with T2DM and established CVD to improve metabolic control, exercise capacity, and quality of life, and to reduce CV events.
• Resistance exercise should be performed in addition to endurance exercise at least twice a week.

Smoking Cessation in Patients with Diabetes

• Smoking cessation is recommended to reduce cardiovascular risk.

Glycaemic Targets

• Tight glycaemic control (HbA1c < 7%) is recommended.

Diagnosis of Diabetes

• Screening for diabetes is recommended in all individuals with CVD, using fasting glucose and/or HbA1c.
• Diagnosis of diabetes should be based on HbA1c and/or fasting plasma glucose, or on an OGTT if still in doubt.

Assessing Cardiovascular Risk in Patients with Diabetes

• Patients with diabetes should be screened for the presence of severe TOD.
• Medical history and symptoms suggestive of ASCVD should be assessed in patients with diabetes.
• In patients with T2DM without symptomatic ASCVD or severe TOD, 10-year CVD risk should be estimated via SCORE2-Diabetes.

Weight Reduction in Patients with Diabetes

• Individuals with diabetes and overweight or obesity should aim to reduce weight and increase physical exercise to improve metabolic control and overall CVD risk profile.

Nutrition in Patients with Diabetes

• Adopting a Mediterranean or plant-based diet with high unsaturated fat content is recommended to lower cardiovascular risk.

Physical Activity/Exercise in Patients with Diabetes

• Increasing physical activity (e.g., 10 min daily walking) is recommended in all patients with T2DM with and without CVD.
• Optimal physical activity is a weekly activity of 150 min of moderate intensity or 75 min of vigorous endurance intensity.
• Exercise interventions should be adapted to T2DM-associated comorbidities, e.g., frailty, neuropathy, or retinopathy.
• Structured exercise training is recommended in patients with T2DM and established CVD to improve metabolic control, exercise capacity, and quality of life, and to reduce CV events.
• Resistance exercise should be performed in addition to endurance exercise at least twice a week.

Smoking Cessation in Patients with Diabetes

• Smoking cessation is recommended to reduce cardiovascular risk.

Glycaemic Targets

• Tight glycaemic control (HbA1c < 7%) is recommended.