DCRM Multispecialty Practice Recommendations for the management of diabetes, cardiorenal, and metabolic diseases

Yehuda Handelsman, John E. Anderson, George L. Bakris, Christie M. Ballantyne, Joshua A. Beckman, Deepak L. Bhatt, Zachary T. Bloomgarden, Biykem Bozkurt, Matthew J. Budoff, Javed Butler, Samuel Dagogo-Jack, Ian H. de Boer, Ralph A. DeFronzo, Robert H. Eckel, Daniel Einhorn, Vivian A. Fonseca, Jennifer B. Green, George Grunberger, Chris Guerin, Silvio E. InzucchiPaul S. Jellinger, Mikhail N. Kosiborod, Pamela Kushner, Norman Lepor, Christian W. Mende, Erin D. Michos, Jorge Plutzky, Pam R. Taub, Guillermo E. Umpierrez, Muthiah Vaduganathan, Matthew R. Weir

Research output: Contribution to journalReview articlepeer-review

Abstract

Type 2 diabetes (T2D), chronic kidney disease (CKD), atherosclerotic cardiovascular disease (ASCVD), and heart failure (HF)—along with their associated risk factors—have overlapping etiologies, and two or more of these conditions frequently occur in the same patient. Many recent cardiovascular outcome trials (CVOTs) have demonstrated the benefits of agents originally developed to control T2D, ASCVD, or CKD risk factors, and these agents have transcended their primary indications to confer benefits across a range of conditions. This evolution in CVOT evidence calls for practice recommendations that are not constrained by a single discipline to help clinicians manage patients with complex conditions involving diabetes, cardiorenal, and/or metabolic (DCRM) diseases. The ultimate goal for these recommendations is to be comprehensive yet succinct and easy to follow by the nonexpert—whether a specialist or a primary care clinician. To meet this need, we formed a volunteer task force comprising leading cardiologists, nephrologists, endocrinologists, and primary care physicians to develop the DCRM Practice Recommendations, a multispecialty consensus on the comprehensive management of the patient with complicated metabolic disease. The task force recommendations are based on strong evidence and incorporate practical guidance that is clinically relevant and simple to implement, with the aim of improving outcomes in patients with DCRM. The recommendations are presented as 18 separate graphics covering lifestyle therapy, patient self-management education, technology for DCRM management, prediabetes, cognitive dysfunction, vaccinations, clinical tests, lipids, hypertension, anticoagulation and antiplatelet therapy, antihyperglycemic therapy, hypoglycemia, nonalcoholic fatty liver disease (NAFLD) and nonalcoholic steatohepatitis (NASH), ASCVD, HF, CKD, and comorbid HF and CKD, as well as a graphical summary of medications used for DCRM.

Original languageEnglish (US)
Article number108101
JournalJournal of Diabetes and Its Complications
DOIs
StateAccepted/In press - 2021

Keywords

  • Atherosclerotic cardiovascular disease
  • Chronic kidney disease
  • Clinical practice
  • Consensus recommendations
  • Heart failure
  • Type 2 diabetes

ASJC Scopus subject areas

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism
  • Endocrinology

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