The 2017 American Diabetes Care Standard was officially promulgated recently. Based on the latest research evidence, the new ADA guidelines update a number of diagnostic and therapeutic recommendations. In the management of cardiovascular diseases and cardiovascular risk factors, the main contents are as follows:
Blood pressure management
1. Diabetes patients should routinely measure blood pressure every time they visit a doctor;
2. The blood pressure control goal of most diabetic patients is <140/90mmHg;
3. In patients with diabetes with high risk factors, blood pressure can be controlled to <130/80mmHg without overly complicated treatment;
4. The target of blood pressure control for pregnant women with diabetes and chronic hypertension is 120-160/80-105mmHg;
5. Diabetes patients with blood pressure >140/90mmHg should start antihypertensive medication immediately after lifestyle intervention, and gradually adjust until blood pressure reaches the standard;
6. Diabetes patients with blood pressure >160/100mmHg should be treated with a combination of two drugs or a single-component combination with evidence of cardiovascular benefit;
7. ACEI, ARB, thiazide diuretics and dihydropyridine CCB can be used for antihypertensive treatment in diabetic patients;
8. In diabetic patients with microalbuminuria, it is recommended to use the maximum tolerated dose of ACEI or ARB as a first-line antihypertensive drug;
9. When using ACEI, ARB or diuretics, attention should be paid to monitoring creatinine, glomerular filtration rate and serum potassium levels;
10. Diabetes patients with blood pressure >120/80 mmHg should initiate lifestyle interventions.
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