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Diabetes
Medical Calculator#Risk#diabetes#vascular

Reducing Vascular Risk in Patients Living with Diabetes

Determine which patients with diabetes require vascular protective therapy

Author / Source: Benjamin Mammon, MD Candidate

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Results

Real-time automated computation

0/10 calculated
Statin Recommended
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ACEi/ARB Recommended
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ASA Recommended
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Liraglutide, Empagliflozin or Canagliflozin Recommended
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Clinical Note:
Recommended even if the baseline blood pressure or LDL-C is at target. Dose adjustments or additional lipid therapy warranted if lipid target (LDL-C <2.0 mmol/L) not being met.

Cautions: Potentially embryopathic – discontinue prior to conception. Try to achieve targets in Canadian Cardiovascular Society guidelines, prescribe up to maximally tolerated and approved dose.
Clinical Note:
Prescribe at doses with demonstrated vascular protection [eg. perindopril 8 mg once daily (EUROPA trial), ramipril 10 mg once daily (HOPE trial), telmisartan 80 mg once daily (ONTARGET trial)].

Cautions: Potentially embryopathic – discontinue prior to conception (used to treat hypertension) or upon detection of pregnancy (used to treat CKD). Caution if hypotensive.
Clinical Note:
Prescribe at doses with demonstrated vascular protection. Go to “Pharmacotherapy for Type 2 Diabetes” for more details. Avoid canagliflozin in patients with risk factors for lower limb amputations.

Cautions: No safety data – discontinue prior to conception.
Clinical Note:
May be indicated per Canadian Cardiovascular Society guidelines.
Clinical Note:
May be indicated for blood pressure control.
Clinical Note:
ASA should not routinely be used for the primary prevention of cardiovascular disease in people with diabetes. ASA may be used for secondary prevention.
Clinical Parameters (0/7)
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Medical calculation formulas standardized according to evidence-based clinical protocols.
About

This tool was developed based on the 2018 Diabetes Canada Clinical Practice Guidelines for the Prevention and Management of Diabetes. Published every five years, these guidelines represent the best and most current evidence-based clinical practice data for healthcare professionals.

Diabetes significantly accelerates the development and natural history of cardiovascular disease compared to individuals without diabetes. Healthy behaviour interventions and pharmacological approaches aimed at cardiovascular disease risk reduction can significantly reduce morbidity and mortality, and are an important cornerstone of the management of diabetes.

Published Literature & References: