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- Title
Lipid Control in the Management of Type 2 Diabetes Mellitus: A Clinical Practice Guideline from the American College of Physicians.
- Authors
Snow, Vincenza; Aronson, Mark D.; Hornbake, E. Rodney; Mottur-Pilson, Christel; Weiss, Kevin B.
- Abstract
In an effort to provide internists and other primary care physicians with effective management strategies for diabetes care, the Clin-ical Efficacy Assessment Subcommittee (CEAS) of the American College of Physicians (ACP) decided to develop guidelines on the management of dyslipidemia, particularly hypercholesterolemia, in people with type 2 diabetes mellitus. The CEAS commissioned a systematic review of the currently available evidence on the man-agement of lipids in type 2 diabetes mellitus. The evidence review is presented in a background paper in this issue. On the basis of this systematic review, the CEAS developed recommendations that the ACP Board of Regents then approved as policy. The target audience for this guideline is all clinicians who care for patients with type 2 diabetes. The target patient popula-tion is all persons with type 2 diabetes, including those who already have some form of microvascular complication and, of particular importance, premenopausal women. The recommenda-tions are as follows. Recommendation 1: Lipid-lowering therapy should be used. for secondary prevention of cardiovascular mortality and morbidity for all patients (both men and women) with known coronary artery disease and type 2 diabetes. Recommendation 2: Statins should be used for primary pre-vention against macrovascular complications in patients (both men and women) with type 2 diabetes and other cardiovascular risk factors. Recommendation 3: Once lipid-lowering therapy is initiated, patients with type 2 diabetes mellitus should be taking at least moderate doses of a statin. Recommendation 4: For those patients with type 2 diabetes who are taking statins, routine monitoring of liver function tests or muscle enzymes is not recommended except in specific circum-stances.
- Subjects
DIABETES; LIPIDS; STATINS (Cardiovascular agents); DISEASES in women; HYPERCHOLESTEREMIA; NONINVASIVE diagnostic tests
- Publication
Annals of Internal Medicine, 2004, Vol 140, Issue 8, p644
- ISSN
0003-4819
- Publication type
Article
- DOI
10.7326/0003-4819-140-8-200404200-00012