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Translating recent results from the Cardiovascular Outcomes Trials into clinical practice: recommendations from the Central and Eastern European Diabetes Expert Group (CEEDEG)

G. Schernthaner, R. Lehmann, M. Prázný, L. Czupryniak, K. Ducena, P. Fasching, A. Janež, A. Karasik, P. Kempler, E. Martinka, MV. Shestakova, LS. Duvnjak, T. Tankova,

. 2017 ; 16 (1) : 137. [pub] 20171023

Language English Country England, Great Britain

Document type Journal Article, Review

Persistent link   https://www.medvik.cz/link/bmc18024538

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.

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$a AIMS: These recommendations aim to improve care for patients with type 2 diabetes (T2D) at high cardiovascular (CV) risk in Central and Eastern Europe. Cardiovascular disease (CVD) and/or chronic kidney disease (CKD) are major interdependent comorbidities in patients with T2D, accounting for 50% of mortality. Following recent CV outcomes trial (CVOT) results, including those from EMPA-REG OUTCOME®, LEADER®, SUSTAIN™-6 and, most recently, the CANVAS study, it is essential to develop regional expert consensus recommendations to aid physicians in interpreting these newest data to clinical practice. METHODS: The Central and Eastern European Diabetes Expert Group (CEEDEG) followed a Delphi method to develop treatment algorithms to aid physicians in the clinical management of patients with T2D at high CV risk. RESULTS: In light of the latest CVOT results, and in particular the EMPA-REG OUTCOME® and LEADER® trials, the diagnosis, assessment, treatment choice and monitoring of patients with T2D and established CVD and/or CKD have been considered together with existing guidelines and presented in two reference algorithms. In addition, adherence, special prescribing considerations and a proposed multidisciplinary management approach have been discussed and are presented with the proposed algorithms. CONCLUSIONS: The latest available high-level evidence on glucose-lowering drugs has enabled CEEDEG to develop practical consensus recommendations for patients with established CVD and/or CKD. These recommendations represent an update to international and country-level guidelines used for these patients, with the aim of providing a resource not only to endocrinologists, but to cardiologists, nephrologists and primary care physicians in the region.
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$a Lehmann, Roger $u Division of Endocrinology and Diabetes of the University Hospital, Zurich, Switzerland.
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$a Prázný, Martin $u Diabetes Centre, Charles University and General Faculty Hospital, Prague, Czech Republic.
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$a Czupryniak, Leszek $u Department of Diabetology and Internal Medicine, Warsaw Medical University, Warsaw, Poland.
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$a Ducena, Kristine $u Faculty of Internal Medicine, University of Latvia, Riga, Latvia.
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$a Fasching, Peter $u 5th Medical Department, Wilhelminenspital, Vienna, Austria.
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$a Janež, Andrej $u Department of Endocrinology, Diabetes and Metabolic Diseases, University Medical Centre, Ljubljana, Slovenia.
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$a Karasik, Avraham $u Chaim Sheba Medical Centre, Tel Hashomer, Israel.
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$a Kempler, Peter $u Department of Medicine, Semmelweis University, Budapest, Hungary.
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$a Martinka, Emil $u National Institute of Endocrinology and Diabetology, Lubochna, Slovakia.
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$a Shestakova, Marina V $u Endocrinology Research Centre, Moscow, Russia.
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$a Duvnjak, Lea Smirčić $u Department of Endocrinology and Metabolic Diseases, Vuk Vrhovac University Clinic for Diabetes, Endocrinology and Metabolic Diseases, Merkur University Hospital, School of Medicine, University of Zagreb, Zagreb, Croatia.
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$a Tankova, Tsvetalina $u Clinical Centre of Endocrinology, Medical University, Sofia, Bulgaria.
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