糖尿病患者合并心血管疾病诊治专家共识

Expert consensus on the management of diabetic patients with cardiovascular diseases

糖尿病是心血管疾病最重要的合并疾病,心血管疾病是2型糖尿病患者致死致残的主要原因。为规范糖尿病合并心血管疾病患者的诊疗,国家卫生健康委员会能力建设和继续教育中心组织心脏科和内分泌科领域的专家,总结国内外相关学科研究进展及专家经验,制定了本共识。本共识分别从心血管疾病和糖尿病管理的角度进行阐述,涵盖糖尿病合并心血管疾病(主要包括动脉粥样硬化性心血管病和心力衰竭)的诊断、药物治疗及危险因素管理等相关的临床重要内容,旨在加强患者的综合管理并最终改善患者预后。心血管疾病的管理主要包括血压、血脂、抗栓、抗心肌缺血、抗心室重构等。糖尿病的管理主要包括生活方式干预、降糖、血糖监测治疗及低血糖预防。此外,本共识还针对特殊人群如糖尿病肾病、高龄(>75岁)及心血管危重症等患者给出了具体的临床建议。

Diabetes is the most important comorbidity of cardiovascular disease,and cardiovascular disease is the main cause of mortality and disability of patients with type 2 diabetes.In order to standardize the diagnosis and treatment of patients with diabetes and cardiovascular disease,the National Health Commission Capacity Building and Continuing Education Center organized the experts from the field of cardiology and endocrinology systematically reviewing the research progresses and expert experiences of relevant disciplines from home and abroad,and formulated this consensus.This consensus covers the diagnosis,drug treatment,and risk factor management for patients with diabetes and cardiovascular disease(including atherosclerotic cardiovascular disease and heart failure)from the perspective of cardiovascular disease and diabetes management aiming to strengthen the comprehensive management of patients and ultimately to improve the prognosis of patients.The management of cardiovascular diseases mainly includes the management of blood pressure,blood lipids,anti-thrombosis,anti-myocardial ischemia,anti-ventricular remodeling and so on.Diabetes management mainly includes lifestyle intervention(including diet,exercise,weight loss,etc.),anti-hyperglycemia therapy(including drugs and insulin),blood glucose monitoring,and hypoglycemic prevention.In addition,specific clinical recommendations are given to patients with special health care needs such as diabetic nephropathy,elderly(>75 years),and cardiovascular critical illness.