ABSTRACT
The risk of atherosclerotic cardiovascular disease (ASCVD) is strongly related to lifetime exposure to low-density lipoprotein (LDL)-cholesterol in longitudinal studies. Lipid-lowering therapy (using statins, ezetimibe and PCSK9 inhibitors) substantially ameliorates the risk and is associated with long-term reduction in cardiovascular (CV) events. The robust evidence supporting these therapies supports their continued (and expanding) role in risk reduction. In addition to these 'conventional' therapeutics, while waiting for other innovative therapies, growing evidence supports the use of a range of 'nutraceuticals' (constituents of food prepared as pharmaceutical formulations) including preparations of red yeast rice (RYR), the product of yeast (Monascus purpureus) grown on rice, which is a constituent of food and is used in traditional Chinese medicine. The major active ingredient, monacolin K, is chemically identical to lovastatin. RYR preparations have been demonstrated to be safe and effective in reducing LDL-C, and CV events. However, surprisingly, RYR has received relatively little attention in international guidelines - and conventional drugs with the strongest evidence for event reduction should always be preferred in clinical practice. Nevertheless, the absence of recommendations relating to RYR may preclude the use of a product which may have clinical utility in particular groups of patients (who may anyway self-prescribe this product), what in the consequence might help to reduce population CV risk. This Position Paper of the International Lipid Expert Panel (ILEP) will use the best available evidence to give advice on the use of red-yeast rice in clinical practice.
Subject(s)
Anticholesteremic Agents , Biological Products , Cardiovascular Diseases , Dyslipidemias , Anticholesteremic Agents/therapeutic use , Biological Products/therapeutic use , Cardiovascular Diseases/drug therapy , Cardiovascular Diseases/prevention & control , Cholesterol , Dyslipidemias/drug therapy , Heart Disease Risk Factors , Humans , Lovastatin/therapeutic use , Proprotein Convertase 9 , Risk Factors , Risk Reduction BehaviorABSTRACT
BACKGROUND: Obesity and its health consequences will dominate health care systems in many countries during the next decades. However, the body mass index (BMI) optimum in relation to all-cause mortality is still a matter of debate. MATERIAL AND METHODS: Data of the Vorarlberg Health Monitoring & Prevention Program (VHM&PP, 1985-2005) and data provided by the Main Association of Austrian Social Security Institutions (MAASSI, 2005-2015) were analyzed. Information was available on age, sex, smoking status, measured height and weight, and mortality. Generalized additive models were used to model mortality as a function of BMI, calendar time, age, and follow-up. RESULTS: In MAASSI (N = 282,216, 46.0% men), men and women were on average 2.7 years older than in VHM&PP (N = 185,361, 46.1% men). Average BMI was slightly higher in men (26.1 vs 25.7 kg/m2) but not in women (24.6 vs 24.7 kg/m2). We found an interactive effect of age and follow-up on the BMI optimum. Over age 35 years in men and 55 years in women, the BMI optimum decreased with length of follow-up. While keeping covariates fixed, BMI optimum increased slightly between 1985 and 2015 in men and women, 24.9 (95% CI, 23.9-25.9) to 26.4 (95% CI, 25.3-27.3), and 22.4 (95% CI, 21.7-23.1) to 23.3 (95% CI, 22.6-24.5) kg/m2, respectively. CONCLUSION: Age and length of follow-up have a pronounced effect on the BMI associated with the lowest all-cause mortality. After controlling for age and length of follow-up, the BMI optimum increased slightly over 30 years in this large study sample.
Subject(s)
Obesity , Adult , Austria/epidemiology , Body Mass Index , Cohort Studies , Female , Follow-Up Studies , Humans , Male , Obesity/epidemiology , Risk FactorsABSTRACT
Several studies have indicated weakly increased risk for kidney cancer among occupational groups exposed to gasoline vapors, engine exhaust, polycyclic aromatic hydrocarbons and other air pollutants, although not consistently. It was the aim to investigate possible associations between outdoor air pollution at the residence and the incidence of kidney parenchyma cancer in the general population. We used data from 14 European cohorts from the ESCAPE study. We geocoded and assessed air pollution concentrations at baseline addresses by land-use regression models for particulate matter (PM10 , PM2.5 , PMcoarse , PM2.5 absorbance (soot)) and nitrogen oxides (NO2 , NOx ), and collected data on traffic. We used Cox regression models with adjustment for potential confounders for cohort-specific analyses and random effects models for meta-analyses to calculate summary hazard ratios (HRs). The 289,002 cohort members contributed 4,111,908 person-years at risk. During follow-up (mean 14.2 years) 697 incident cancers of the kidney parenchyma were diagnosed. The meta-analyses showed higher HRs in association with higher PM concentration, e.g. HR = 1.57 (95%CI: 0.81-3.01) per 5 µg/m3 PM2.5 and HR = 1.36 (95%CI: 0.84-2.19) per 10-5 m-1 PM2.5 absorbance, albeit never statistically significant. The HRs in association with nitrogen oxides and traffic density on the nearest street were slightly above one. Sensitivity analyses among participants who did not change residence during follow-up showed stronger associations, but none were statistically significant. Our study provides suggestive evidence that exposure to outdoor PM at the residence may be associated with higher risk for kidney parenchyma cancer; the results should be interpreted cautiously as associations may be due to chance.
Subject(s)
Air Pollutants/adverse effects , Kidney Neoplasms/diagnosis , Kidney Neoplasms/epidemiology , Adult , Air Pollution/adverse effects , Cohort Studies , Environmental Exposure/adverse effects , Europe/epidemiology , Female , Gasoline , Humans , Lung Neoplasms/epidemiology , Male , Middle Aged , Particle Size , Particulate Matter , Risk Factors , Vehicle EmissionsABSTRACT
UNLABELLED: Low density lipoprotein (LDL-C) levels determine the cardiovascular risk. Previous studies indicated an LDL-C target attainment of around 50%, but no Austrian wide analysis on results for the federal states was available. We therefore sought to detect potential differences. DESIGN: Open-label, non-interventional, longitudinal study, registered: www.clinicaltrials.gov NCT 01381679. In all, 746 statin treated patients not at LDL-C goal received intensified therapy for 12 months. The sample was split into nine subgroups, representing the federal states of Austria.We detected an east-west gradient for baseline LDL-C. Individual target values were achieved by 37.2% (range: 26.1-57.7%). After 12 months, LDL-C < 70 mg/l was achieved by 13.5% (5.9-38.5%). Univariate ANCOVA retrieved significant differences within the states (Upper Austria and Salzburg, p = 0.001 and p = 0.0015, respectively). Furthermore, the capacity of intensified lipid lowering therapy applied in practice was as high as -42% as compared to previous standard therapy (additional LDL-C reduction after switch from baseline therapy in Vorarlberg).
Subject(s)
Anticholesteremic Agents/therapeutic use , Azetidines/therapeutic use , Cholesterol, LDL/blood , Hydroxymethylglutaryl-CoA Reductase Inhibitors/therapeutic use , Hypercholesterolemia/blood , Hypercholesterolemia/drug therapy , Aged , Austria , Cross-Sectional Studies , Drug Resistance , Ezetimibe , Female , Humans , Hypercholesterolemia/epidemiology , Longitudinal Studies , Male , Middle Aged , Retreatment , Topography, MedicalABSTRACT
Hyper- and dyslipidemia contribute to cardiovascular morbidity and mortality in diabetic patients. Pharmacological therapy to lower LDL cholesterol has convincingly shown to reduce cardiovascular risk in diabetic patients. The present article represents the recommendations of the Austrian Diabetes Association for the use of lipid-lowering drugs in diabetic patients according to current scientific evidence.
Subject(s)
Diabetes Mellitus, Type 2 , Dyslipidemias , Hydroxymethylglutaryl-CoA Reductase Inhibitors , Humans , Hydroxymethylglutaryl-CoA Reductase Inhibitors/therapeutic use , Diabetes Mellitus, Type 2/diagnosis , Diabetes Mellitus, Type 2/drug therapy , Hypolipidemic Agents/therapeutic use , Dyslipidemias/diagnosis , Dyslipidemias/drug therapy , Cholesterol, LDL , Risk FactorsABSTRACT
Hyperglycemia significantly contributes to complications in patients with diabetes mellitus. While lifestyle interventions remain cornerstones of disease prevention and treatment, most patients with type 2 diabetes will eventually require pharmacotherapy for glycemic control. The definition of individual targets regarding optimal therapeutic efficacy and safety as well as cardiovascular effects is of great importance. In this guideline we present the most current evidence-based best clinical practice data for healthcare professionals.
Subject(s)
Diabetes Mellitus, Type 2 , Hyperglycemia , Humans , Hypoglycemic Agents/therapeutic use , Diabetes Mellitus, Type 2/diagnosis , Diabetes Mellitus, Type 2/drug therapy , Diabetes Mellitus, Type 2/complications , Hyperglycemia/drug therapy , Blood GlucoseABSTRACT
The primary defect underlying abnormalities in lipoprotein transport in type 2 diabetes is insulin resistance, which leads to increased triglycerides in the fasting and postprandial states, preponderance of small, dense LDL and low concentrations of dysfunctional HDL. Concentrations of LDL-cholesterol (LDL-C) are most often not remarkably abnormal. Based on this lipoprotein profile, it seems somewhat counterintuitive to prioritize LDL-C lowering in type 2 diabetes. Nevertheless, ≈20 years of statins trials in >18,000 diabetic patients have unequivocally established this priority. Patients with type 2 diabetes without manifest atherosclerosis should reach an LDL-C goal <100 mg/dl or a Non-HDLcholesterol (NHDL-C) goal <130 mg/dl. If their baseline LDL-C is already between 70 and 100 mg/dl LDL-C should be lowered by 30 to 40%. Thus, the majority of these patients can be managed successfully with monotherapy using standard-intensity statins (e.g. simvastatin 40 mg/d). Patients with type 2 diabetes with manifest CHD should reach an LDL-C goal <70 mg/dl or an NHDL-C goal <100 mg/dl. A sizable fraction of these patients will require high-intensity statins (e.g. atorvastatin 80 mg/d or rosuvastatin 20-40 mg/d). If LDL-C goals are still not reached or high-intensity statins are not tolerated, combination of statins with ezetimibe is advisable. In patients with persistent pronounced dyslipidemic features, i.e. high TG/low HDL-C despite maximal lifestyle intervention and optimized statin dosage, pioglitazone should be incorporated in the antidiabetic management and combinations of statins with either niacin or fenofibrate should be considered. However, it has to be recognized that evidence supporting HDL-raising therapy is currently still much weaker than evidence supporting LDL lowering with statins.
Subject(s)
Anticholesteremic Agents/therapeutic use , Diabetes Mellitus, Type 2/drug therapy , Hypercholesterolemia/drug therapy , Anticholesteremic Agents/adverse effects , Cholesterol, HDL/blood , Cholesterol, LDL/blood , Combined Modality Therapy , Diabetes Mellitus, Type 2/blood , Drug Therapy, Combination , Humans , Hydroxymethylglutaryl-CoA Reductase Inhibitors/adverse effects , Hydroxymethylglutaryl-CoA Reductase Inhibitors/therapeutic use , Hypercholesterolemia/blood , Hypoglycemic Agents/adverse effects , Hypoglycemic Agents/therapeutic use , Life Style , Triglycerides/bloodABSTRACT
The availability of efficient lipid-lowering drugs has substantially reduced the incidence and mortality for cardiovascular disease (CVD). Despite that, CVD still represents a major cause of death and disability; efforts are thus required to prevent this disease, since reducing the established CV risk factors may slow or prevent the onset of cardiovascular events. Current guidelines recommend a healthier lifestyle for all CV risk categories, as it may have a beneficial impact on several risk factors; in individuals with a low-to-moderate hypercholesterolemia, which are not eligible for a pharmacological approach and are not far from the cholesterol target recommended for their risk category, functional foods or nutraceuticals may be considered as supplement to reduce their CV risk status. Of note, counseling and lifestyle intervention in people at moderate CV risk represents a major issue for both preventing a further risk increase and reducing the need for drugs. Studies on general populations have clearly indicated that lifestyle interventions translate into a clinical benefit, with reduction of the incidence of myocardial infarction and the risk of developing type 2 diabetes.
Subject(s)
Cardiovascular Diseases/prevention & control , Hypercholesterolemia/therapy , Counseling , Diet , Dietary Supplements , Exercise , Humans , Life Style , Risk Reduction Behavior , Weight LossABSTRACT
In critical illness hyperglycemia is associated with increased mortality. Based on the currently available evidence, an intravenous insulin therapy should be initiated when blood glucose is above 180â¯mg/dl. After initiation of insulin therapy blood glucose should be maintained between 140 and 180â¯mg/dl.
Subject(s)
Critical Illness , Hyperglycemia , Hypoglycemic Agents/therapeutic use , Practice Guidelines as Topic , Adult , Blood Glucose/metabolism , Critical Care , Humans , Hyperglycemia/therapy , Insulin/therapeutic useABSTRACT
Hyper- and dyslipidemia contribute to cardiovascular morbidity and mortality in diabetic patients. Pharmacological therapy to lower LDL cholesterol has convincingly shown to reduce cardiovascular risk in diabetic patients. The present article represents the recommendations of the Austrian Diabetes Association for the use of lipid-lowering drugs in diabetic patients according to current scientific evidence.
Subject(s)
Diabetes Complications/drug therapy , Dyslipidemias , Hydroxymethylglutaryl-CoA Reductase Inhibitors , Hypolipidemic Agents/therapeutic use , Austria , Cardiovascular Diseases/drug therapy , Cardiovascular Diseases/epidemiology , Comorbidity , Dyslipidemias/drug therapy , Dyslipidemias/epidemiology , Humans , Hydroxymethylglutaryl-CoA Reductase Inhibitors/therapeutic use , Lipids , Practice Guidelines as Topic , Risk FactorsABSTRACT
BACKGROUND: The wearable cardioverter-defibrillator is a treatment option for patients at temporarily high risk of sudden cardiac death or in whom implantation of a cardioverter-defibrillator is temporarily not possible. OBJECTIVES: The aim of this study was to provide real-world data on patients receiving this therapy in a nurse-based wearable cardioverter-defibrillator training programme. METHODS: A registry including all patients prescribed with a wearable cardioverter-defibrillator in Austria between 2010 and 2016. Overall, 448 patients received a wearable cardioverter-defibrillator in 48 centres. Patients received structured nurse-based wearable cardioverter-defibrillator educational initial training followed by remote monitoring. RESULTS: Main indications were: severe non-ischaemic cardiomyopathy (21%); recent myocardial infarction and percutaneous coronary intervention (20%); and stable coronary artery disease with percutaneous coronary intervention/coronary artery bypass grafting (14%). Eleven patients (2.5%) received 22 appropriate wearable cardioverter-defibrillator shocks. Two patients (0.4%) received three inappropriate shocks. The risk of sudden cardiac death varied between different aetiologies. Eight out of 11 (73%) patients received their first wearable cardioverter-defibrillator shock within 30 days. The main reasons for termination of the wearable cardioverter-defibrillator therapy were implantable cardioverter-defibrillator implantation (55.5%) and improvement of left ventricular ejection fraction to more than 35% (33%). CONCLUSION: The wearable cardioverter-defibrillator is an effective and safe treatment option in patients at either transiently elevated risk of ventricular tachycardia/ventricular fibrillation or mandated postponed implantable cardioverter-defibrillator implantation, with a 2.5% shock rate over a median 54 days wearable cardioverter-defibrillator treatment period. However, both the wearable cardioverter-defibrillator shock rate and implantable cardioverter-defibrillator implantation rate vary widely depending on the wearable cardioverter-defibrillator indication. Nurse-based wearable cardioverter-defibrillator training is associated with high patient adherence, with a median wearing duration per day of 23.5 (1-24) hours.
Subject(s)
Arrhythmias, Cardiac/therapy , Patient Compliance/psychology , Patient Compliance/statistics & numerical data , Patient Education as Topic/statistics & numerical data , Wearable Electronic Devices/psychology , Wearable Electronic Devices/statistics & numerical data , Adult , Aged , Aged, 80 and over , Austria , Female , Humans , Male , Middle Aged , Registries , Time Factors , Treatment OutcomeABSTRACT
The present article is a recommendation of the Austrian Diabetes Association for the practical use of insulin in type 2 diabetes, including the various insulin regimens.
Subject(s)
Diabetes Mellitus, Type 2 , Hypoglycemic Agents/therapeutic use , Insulin/therapeutic use , Practice Guidelines as Topic , Austria , Diabetes Mellitus, Type 2/drug therapy , Dose-Response Relationship, Drug , Drug Administration Schedule , HumansABSTRACT
Hyperglycemia significantly contributes to complications in patients with diabetes mellitus. While lifestyle interventions remain cornerstones of disease prevention and treatment, most patients with type 2 diabetes will eventually require pharmacotherapy for glycemic control. The definition of individual targets regarding optimal therapeutic efficacy and safety as well as cardiovascular effects is of great importance. In this guideline we present the most current evidence-based best clinical practice data for healthcare professionals.
Subject(s)
Blood Glucose/drug effects , Diabetes Mellitus, Type 2 , Hypoglycemic Agents/therapeutic use , Practice Guidelines as Topic , Blood Glucose/metabolism , Diabetes Mellitus, Type 2/drug therapy , Humans , Hyperglycemia/drug therapy , Life StyleABSTRACT
Elevated blood pressure remains a major cause of cardiovascular disease, disability, and premature death in Austria, with suboptimal rates of detection, treatment and control also in recent years. Management of hypertension is a common challenge for physicians with different spezializations. In an attempt to standardize diagnostic and therapeutic strategies and, ultimately, to increase the rate of patients with controlled blood pressure and to decrease the burden of cardiovascular disease, 13 Austrian medical societies reviewed the evidence regarding prevention, detection, workup, treatment and consequences of high blood pressure in general and in various clinical scenarios. The result is presented as the first national consensus on blood pressure. The authors and societies involved are convinced that a joint national effort is needed to decrease hypertension-related morbidity and mortality in our country.
Subject(s)
Antihypertensive Agents , Cardiovascular Diseases , Hypertension , Antihypertensive Agents/therapeutic use , Austria , Blood Pressure , Cardiovascular Diseases/prevention & control , Consensus , Humans , Hypertension/complications , Hypertension/drug therapyABSTRACT
BACKGROUND: Obesity is suggested to underlie development of other metabolic aberrations, but longitudinal relationships between metabolic factors at various ages has not been studied in detail. METHODS: Data from 27,379 men and 32,275 women with in total 122,940 health examinations in the Västerbotten Intervention Project, Sweden and the Vorarlberg Health Monitoring and Prevention Programme, Austria were used to investigate body mass index (BMI), mid-blood pressure, and fasting levels of glucose, triglycerides, and total cholesterol at baseline in relation to 10-year changes of these factors and weight. We included paired examinations performed 10±2 years apart and used them for longitudinal analysis with linear regression of changes between the ages 30 and 40, 40 and 50, or 50 and 60 years. RESULTS: Higher levels of BMI were associated with increases in glucose and mid-blood pressure as well as triglycerides levels, and, to a lesser extent, decreases in cholesterol levels. For instance, per 5 kg/m2 higher BMI at age 40, glucose at age 50 increased by 0.24 mmol/l (95%CI: 0.22-0.26) and mid-blood pressure increased by 1.54 mm Hg (95%CI: 1.35-1.74). The strongest association observed was between BMI at age 30 and mid-blood pressure, which was 2.12 mm Hg (95% CI: 1.79-2.45) increase over ten years per 5 kg/m2 higher BMI level. This association was observed at an age when blood pressure levels on average remained stable. Other associations than those with BMI at baseline were much weaker. However, triglyceride levels were associated with future glucose changes among individuals with elevated BMI, particularly in the two older age groups. CONCLUSION: BMI was most indicative of long-term changes in metabolic factors, and the strongest impact was observed for increases in blood pressure between 30 and 40 years of age. Our study supports that lifestyle interventions preventing metabolic aberrations should focus on avoiding weight increases.
Subject(s)
Body Mass Index , Dyslipidemias/epidemiology , Hyperglycemia/epidemiology , Hypertension/epidemiology , Adult , Austria/epidemiology , Female , Humans , Longitudinal Studies , Male , Middle Aged , Sweden/epidemiologyABSTRACT
Previous literature indicates that pre-diagnostic diabetes and blood glucose levels are inversely related to glioma risk. To replicate these findings and determine whether they could be attributed to excess glucose consumption by the preclinical tumour, we used data from the Apolipoprotein MOrtality RISk (AMORIS) (n = 528,580) and the Metabolic syndrome and Cancer project (Me-Can) cohorts (n = 269,365). We identified individuals who were followed for a maximum of 15 years after their first blood glucose test until glioma diagnosis, death, emigration or the end of follow-up. Hazard ratios (HRs), 95% confidence intervals (CIs) and their interactions with time were estimated using Cox time-dependent regression. As expected, pre-diagnostic blood glucose levels were inversely related to glioma risk (AMORIS, P trend = 0.002; Me-Can, P trend = 0.04) and pre-diagnostic diabetes (AMORIS, HR = 0.30, 95% CI 0.17 to 0.53). During the year before diagnosis, blood glucose was inversely associated with glioma in the AMORIS (HR = 0.78, 95% CI 0.66 to 0.93) but not the Me-Can cohort (HR = 0.99, 95% CI 0.63 to 1.56). This AMORIS result is consistent with our hypothesis that excess glucose consumption by the preclinical tumour accounts for the inverse association between blood glucose and glioma. We discuss additional hypothetical mechanisms that may explain our paradoxical findings.
Subject(s)
Blood Glucose/metabolism , Brain Neoplasms/diagnosis , Diabetes Mellitus, Type 2/diagnosis , Glioma/diagnosis , Prediabetic State/diagnosis , Adult , Aged , Biomarkers/blood , Brain Neoplasms/blood , Brain Neoplasms/mortality , Brain Neoplasms/pathology , Diabetes Mellitus, Type 2/blood , Diabetes Mellitus, Type 2/mortality , Diabetes Mellitus, Type 2/pathology , Female , Glioma/blood , Glioma/mortality , Glioma/pathology , Humans , Longitudinal Studies , Male , Middle Aged , Prediabetic State/blood , Prediabetic State/mortality , Prediabetic State/pathology , Prognosis , Proportional Hazards Models , Risk Factors , Time FactorsABSTRACT
In critical illness hyperglycemia is associated with increased mortality. Based on the currently available evidence, an intravenous insulin therapy should be initiated when blood glucose is above 180 mg/dl. After initiation of insulin therapy blood glucose should be maintained between 140 and 180 mg/dl.
Subject(s)
Critical Care/standards , Critical Illness/therapy , Hyperglycemia/diagnosis , Hyperglycemia/drug therapy , Insulin/administration & dosage , Practice Guidelines as Topic , Adult , Austria , Dose-Response Relationship, Drug , Drug Administration Schedule , Evidence-Based Medicine , Female , Humans , Hyperglycemia/blood , Hyperglycemia/prevention & control , Hypoglycemic Agents/administration & dosage , Male , Treatment OutcomeABSTRACT
Hyper- and dyslipidemia contribute to cardiovascular morbidity and mortality in diabetic patients. Pharmacological therapy to lower LDL cholesterol has convincingly shown to reduce cardiovascular risk in diabetic patients. The present article represents the recommendations of the Austrian Diabetes Association for the use of lipid-lowering drugs in diabetic patients according to current scientific evidence.
Subject(s)
Diabetes Complications/drug therapy , Diabetic Cardiomyopathies/drug therapy , Hyperlipidemias/drug therapy , Hyperlipidemias/prevention & control , Hypolipidemic Agents/administration & dosage , Practice Guidelines as Topic , Austria , Diabetes Complications/complications , Diabetic Cardiomyopathies/etiology , Diabetic Cardiomyopathies/prevention & control , Dose-Response Relationship, Drug , Drug Administration Schedule , Evidence-Based Medicine , Humans , Hydroxymethylglutaryl-CoA Reductase Inhibitors/administration & dosage , Hyperlipidemias/etiology , Treatment OutcomeABSTRACT
In 2010, eight Austrian medical societies proposed a joint position statement on the management of metabolic lipid disorders for the prevention of vascular complications. An updated and extended version of these recommendations according to the current literature is presented, referring to the primary and secondary prevention of vascular complications in adults, taking into consideration the guidelines of other societies. The "Austrian Lipid Consensus - 2016 update" provides guidance for individualized risk stratification and respective therapeutic targets, and discusses the evidence for reducing vascular endpoints with available lipid-lowering therapies. Furthermore, specific management in key patient groups is outlined, including subjects presenting with coronary, cerebrovascular, and/or peripheral atherosclerosis; diabetes mellitus and/or metabolic syndrome; nephropathy; and familial hypercholesterolemia.
Subject(s)
Hypolipidemic Agents/administration & dosage , Lipid Metabolism Disorders/complications , Lipid Metabolism Disorders/therapy , Practice Guidelines as Topic , Vascular Diseases/etiology , Vascular Diseases/prevention & control , Austria , Cardiology/standards , Evidence-Based Medicine , Humans , Lipid Metabolism Disorders/diagnosis , Treatment Outcome , Vascular Diseases/diagnosisABSTRACT
Hyperglycemia significantly contributes to micro- and macrovascular complications in patients with diabetes mellitus. While lifestyle interventions remain cornerstones of disease prevention and treatment, most patients with type 2 diabetes will eventually require pharmacotherapy for glycemic control. The definition of individual targets regarding optimal therapeutic efficacy and safety is of great importance. In this guideline we present the most current evidence-based best clinical practice data for healthcare professionals.