Primary Prevention of ASCVD and T2DM in Patients at Metabolic Risk
Key Points
Key Points
- Individuals should be screened for metabolic risk, in five categories:
- Elevated waist circumference
- Decreased high density lipoprotein (HDL) cholesterol
- Elevated serum triglycerides
- Elevated blood pressure
- Elevated blood glucose
- Three or more categories being abnormal should alert the clinician to a patient’s increased risk for atherosclerotic cardiovascular disease (ASCVD) and type 2 diabetes mellitus (T2DM) (i.e., metabolic risk).
- Endocrine Society (ES) recommends that providers measure waist circumference as part of the initial evaluation. (Note: However, that this does not replace the measurement of weight.)
- Behavioral change should be the first-line therapy for prevention and should include changes to diet, increased exercise, and weight loss.
- Persons identified as having metabolic risk should undergo risk scoring to identify the 10-year risk for ASCVD.
Diagnosis
...gnosis
...ions and Diagnosis...
...: In individuals aged 40–75 years in th...
...ndividuals aged 40–75 years in the office se...
...sh metabolic risk in the general popula...
...duals previously diagnosed with prediabetes, ES s...
...5: ES recommends that all individuals at metaboli...
...iduals with elevated blood pressure >130 mmHg s...
...ia Proposed for Clinical Diagnosis of the Metaboli...
...w Chart for the Assessment and Treatment of M...
...ing Waist Circumference According...
...Recommended Waist Thresholds to Define Abdomin...
...tions of Prediabetes (Intermediate...
Treatment
...eatment...
...yle and Behavioral Therapy
...In individuals at metabolic risk, ES recommends th...
...: For individuals at metabolic risk wit...
...In individuals at metabolic risk, ES re...
...viduals at metabolic risk, ES recommends prescri...
...ct of Lifestyle Components on Metabolic Parame...
...omponents of Healthy Cardiovascular...
...able 6. Nutrient Action Nut...
...edical and Pharmacological Th...
...k Assessment and Evalua...
...individuals identified as having metabolic...
...iduals with low density lipoprotein-cholesterol...
...olesterol Reduc...
...iduals 40–75 years of age with LDL-C ≥190 mg/d...
...uals 40–75 years of age with LDL-C...
...dividuals 40–75 years of age without dia...
...In individuals 40–75 years of age without dia...
...In individuals with metabolic risk, without...
...individuals aged >75 years without diabete...
...individuals at metabolic risk who...
...dividuals aged 40 years and older at me...
...in TherapyHaving trouble viewing table...
...ent Recommendations and LDL-C Goals for Treatmen...
...od Pressure Reduction
...uals with blood pressure above 130/80 mmHg and a t...
...iduals without a history of ASCVD with metabolic...
...ucing Progression to Type 2...
...duals with prediabetes, ES recommends pres...
...10: In individuals with prediabetes who have...