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Diabetes: Difference between revisions
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===Treatments and outcomes=== | ===Treatments and outcomes=== | ||
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!colspan="3"|Arrhythmias: atrial fibrillation and sudden cardiac death<cite>34</cite> | |||
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|bgcolor="#CCCCFF" colspan="3"| | |||
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!Recommendation | |||
!Class<sup>a</sup> | |||
!Level<sup>b</sup> | |||
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|Aspirin and anticoagulant use as recommended for patients with atrial fibrillation should be rigorously applied in diabetic patients with atrial fibrillation to prevent stroke | |||
!I | |||
!C | |||
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|Chronic oral anticoagulant therapy in a dose adjusted to achieve a target international normalized ratio (INR) of 2–3 should be considered in all patients with atrial fibrillation and diabetes, unless contraindicated | |||
!IIa | |||
!C | |||
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|Control of glycaemia even in the pre-diabetic stage is important to prevent the development of the alterations that predispose to sudden cardiac death | |||
!I | |||
!C | |||
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|Microvascular disease and nephropathy are indicators of increased risk of sudden cardiac death in diabetic patients | |||
!IIa | |||
!B | |||
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|bgcolor="#CCCCFF" colspan="3"| | |||
'''<sup>a</sup>Class of recommendation. | |||
'''<sup>b</sup>Level of evidence. | |||
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Aspirin and anticoagulant use as recommended for patients with atrial fibrillation should be rigorously applied in diabetic patients with atrial fibrillation to prevent heart stroke. Oral anticoagulation is most beneficial for patients at higher risk for stroke, whereas the risks outweigh the benefit in patients at low risk.<cite>50</cite> Thus, quantifying the risk of stroke is crucial for determining which atrial fibrillation patients would benefit most from anticoagulant therapy. | Aspirin and anticoagulant use as recommended for patients with atrial fibrillation should be rigorously applied in diabetic patients with atrial fibrillation to prevent heart stroke. Oral anticoagulation is most beneficial for patients at higher risk for stroke, whereas the risks outweigh the benefit in patients at low risk.<cite>50</cite> Thus, quantifying the risk of stroke is crucial for determining which atrial fibrillation patients would benefit most from anticoagulant therapy. | ||