Guidelines presents Primary Care Hacks, a series of clinical aide-memoires across a range of topics. Developed by Dr Kevin Fernando, Primary Care Hacks aim to provide a quick and easy resource for primary healthcare professionals and ultimately help improve patients' lives.
Take a Look at Medscape UK's other Primary Care Hacks
|Managing Abnormal Blood Test Results||Managing Cardiovascular Conditions||Managing Diabetes, Metabolic, and Endocrine Disorders|
Type 2 Diabetes Cardiovascular Renal Metabolic Review Checklist
The care of people living with type 2 diabetes (T2D) is increasingly complex, given the interconnected nature of the cardiovascular, renal, and metabolic (CVRM) systems, and recent evidence and guidance recommends that we think beyond glycaemia when managing individuals with T2D in primary care. This CVRM checklist is an aide-memoire for the care of people living with T2D and highlights recommendations and resources to facilitate a holistic approach in primary care settings.
Expand the table below for full view.
|Consider the Following During T2D CVRM Shared Decision Making:|
|Individualised HbA1c Goals|
|There is considerable debate around optimal BP targets for people living with diabetes, with several conflicting guidelines published|
|Comorbidities and Life Story|
|ACEi=angiotensin-converting enzyme inhibitor; ACR=albumin to creatinine ratio; ARB=angiotensin receptor blockers; ASCVD=atherosclerotic cardiovascular disease; BP=blood pressure; CBG=capillary blood glucose; CGM=continuous glucose monitoring; CHF=congestive heart failure; CKD=chronic kidney disease; CVD=cardiovascular disease; CVRM=cardiovascular, renal, and metabolism; DBP=diastolic blood pressure; DESMOND=diabetes education and self-management for ongoing and newly diagnosed; DSMES=diabetes self-management, education, and support; DSN=diabetes specialist nurse; DVLA=Driver and Vehicle Licensing Agency; eGFR=estimated glomerular filtration rate; FIB-4=Fibrosis-4; GLP-1 RA=glucagon-like peptide-1 receptor agonist; HbA1c=haemoglobin A1c; HBPM=home blood pressure monitoring; HDL-C=high-density lipoprotein cholesterol; HF=heart failure; HFpEF=heart failure with preserved ejection fraction; HFrEF=heart failure with reduced ejection fraction; IHD=ischaemic heart disease; LDL-C=low-density lipoprotein cholesterol; MASH=metabolic dysfunction-associated steatohepatitis; MASLD=metabolic dysfunction-associated steatotic liver disease; MDT=multidisciplinary team; OSAHS=obstructive sleep apnoea hypopnoea syndrome; PARS=Physical Activity Referral Service; PVD=peripheral vascular disease; QRISK3=Cardiovascular Risk Score 3; SGLT2i=sodium–glucose cotransporter-2 inhibitor; SBP=systolic blood pressure; STOP–BANG=snoring history, tired during the day, observed stop breathing while sleep, high blood pressure, BMI >35 kg/m2, age >50 years, neck circumference >40 cm, and male gender; SU=sulfonylurea; TIA=transient ischaemic attack; TG=triglyceride; T2D=type 2 diabetes; WHR=waist to hip ratio.|
|This Primary Care Hack was developed by Dr Eimear Darcy, GP Partner, Grange Family Practice Omagh; and Dr Kevin Fernando, GP Partner, North Berwick Health Centre, GP with special interest in CVRM and medical education, and Content Advisor for Medscape UK and Medscape Global. Primary Care Hacks are for information for primary healthcare professionals in the UK only. They bring together currently available recommendations and/or prescribing information and indications for therapeutics licensed within Great Britain. Licensed indications and/or prescribing information for Northern Ireland may differ. You are advised to review local licensed indications before prescribing any therapeutic. Primary Care Hacks are reviewed intermittently to ensure the information is up to date at the time of publication. Primary Care Hacks are independently produced by WebMD, LLC and have not been created in conjunction with any guideline or prescribing body.|
Erratum: In a previously published version of this Primary Care Hack, it was recommended to consider icosapent ethyl in patients with established CVD (secondary prevention) and on statins with fasting TG ≥1.7mmol/l and LDL-C between 1.04 and ≤2.06 mmol/l. This has now been corrected to fasting TG ≥1.7mmol/l and LDL-C between 1.04 and ≤2.60 mmol/l.