DCRM Multispecialty Practice Recommendations for the management of diabetes, cardiorenal, and metabolic diseases

• Type of Material: Article
• Authors: Yehuda Handelsman, Metabolic Institute of America; John E Anderson, University of Chicago; George L Bakris, Univ Chicago Med; Chrsitie M Ballantyne, Baylor College of Medicine; Joshua A Beckman, Vanderbilt University; Deepak L Bhatt, Harvard Medical School; Zachary T Bloomgarden, Mount Sinai School of Medicine; Biykem Bozkurt, Baylor College of Medicine; Matthew J Budoff, University of California Los Angeles; Javed Butler, Emory University; Samuel Dagogo-Jack, University of Tennessee Health Science Center; Ian H de Boer, University of Washington; Ralph A DeFronzo, University of Texas Health Science Center; Robert H Eckel, University of Colorado, Denver; Daniel Einhorn, Scripps Whittier Institute for Diabetes; Vivian A Fonseca, Tulane University; Jennifer B Green, Duke University; George Grunberger, Grunberger Diabetes Institute; Chris Guerin, University of California San Diego; Silvio E Inzucchi, Yale School of Medicine; Paul S Jellinger, University of Miami Miller School of Medicine; Mikhail N Kosiborod, University of Missouri Kansas City; Pamela Kushner, University of California Irvine; Norman Lepor, University of California Los Angeles; Christian W Mende, University of California San Diego; Erin D Michos, Johns Hopkins University; Jorge Plutzky, Harvard Medical School; Pam R Taub, University of California San Diego; Guillermo Umpierrez, Emory University; Muthiah Vaduganathan, Harvard Medical School; Matthew R Weir, University of Maryland, Baltimore
• Language: English
• Date: 2022-02-01
• Publisher: ELSEVIER SCIENCE INC
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: © 2021 The Authors.
• License: Creative Commons Attribution 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.1016/j.jdiacomp.2021.108101
• Title of Journal or Parent Work: JOURNAL OF DIABETES AND ITS COMPLICATIONS
• Volume: 36
• Issue: 2
• Start Page: 108101
• End Page: 108101
• Keywords: AMERICAN-COLLEGE; KIDNEY-DISEASE; 2013 ACCF/AHA GUIDELINE; Heart failure; CLINICAL-PRACTICE GUIDELINES; Science & Technology; FATTY LIVER-DISEASE; Endocrinology & Metabolism; Clinical practice; ASSOCIATION TASK-FORCE; CARDIOVASCULAR OUTCOMES; Chronic kidney disease; Consensus recommendations; CORONARY-HEART-DISEASE; STATIN THERAPY; NONALCOHOLIC STEATOHEPATITIS; Life Sciences & Biomedicine; Atherosclerotic cardiovascular disease; Type 2 diabetes

Abstract

Type 2 diabetes (T2D), chronic kidney disease (CKD), atherosclerotic cardiovascular disease (ASCVD), and heart failure (HF)—along with their associated risk factors—have overlapping etiologies, and two or more of these conditions frequently occur in the same patient. Many recent cardiovascular outcome trials (CVOTs) have demonstrated the benefits of agents originally developed to control T2D, ASCVD, or CKD risk factors, and these agents have transcended their primary indications to confer benefits across a range of conditions. This evolution in CVOT evidence calls for practice recommendations that are not constrained by a single discipline to help clinicians manage patients with complex conditions involving diabetes, cardiorenal, and/or metabolic (DCRM) diseases. The ultimate goal for these recommendations is to be comprehensive yet succinct and easy to follow by the nonexpert—whether a specialist or a primary care clinician. To meet this need, we formed a volunteer task force comprising leading cardiologists, nephrologists, endocrinologists, and primary care physicians to develop the DCRM Practice Recommendations, a multispecialty consensus on the comprehensive management of the patient with complicated metabolic disease. The task force recommendations are based on strong evidence and incorporate practical guidance that is clinically relevant and simple to implement, with the aim of improving outcomes in patients with DCRM. The recommendations are presented as 18 separate graphics covering lifestyle therapy, patient self-management education, technology for DCRM management, prediabetes, cognitive dysfunction, vaccinations, clinical tests, lipids, hypertension, anticoagulation and antiplatelet therapy, antihyperglycemic therapy, hypoglycemia, nonalcoholic fatty liver disease (NAFLD) and nonalcoholic steatohepatitis (NASH), ASCVD, HF, CKD, and comorbid HF and CKD, as well as a graphical summary of medications used for DCRM.