Exp Clin Endocrinol Diabetes 2019; 127(S 01): S102-S104
DOI: 10.1055/a-1018-9065
German Diabetes Association: Clinical Practice Guidelines
© Georg Thieme Verlag KG Stuttgart · New York

Diabetes Mellitus and the Heart

Katharina Schütt
1   Medical Clinic I - Cardiology, Angiology and Internal Intensive Care Medicine, RWTH Aachen University Hospital, Aachen, Germany
,
Dirk Müller-Wieland
1   Medical Clinic I - Cardiology, Angiology and Internal Intensive Care Medicine, RWTH Aachen University Hospital, Aachen, Germany
,
Nikolaus Marx
1   Medical Clinic I - Cardiology, Angiology and Internal Intensive Care Medicine, RWTH Aachen University Hospital, Aachen, Germany
› Author Affiliations
Further Information

Publication History

Publication Date:
20 December 2019 (online)

Cardiovascular Risk

Patients with diabetes mellitus (DM) have a significantly increased risk of developing cardiovascular diseases with their sequelae of acute myocardial infarction, stroke and cardiovascular death. For example, even today a 60-year-old diabetic man has 6 years less life expectancy compared to a non-diabetic man of the same age, and a 60-year-old with diabetes and a previous history of a heart attack has 12 years less [1]. These data highlight the need for targeted risk stratification of patients with diabetes and the consistent treatment of diabetes, associated risk factors and cardiovascular disease.

Patients with diabetes mellitus should be categorized according to their cardiovascular risk into those with very high cardiovascular risk, high cardiovascular risk and moderate cardiovascular risk [2].

Very high cardiovascular risk

DM and existing cardiovascular disease, or end organ damage, or  ≥  3 risk factors or diabetes duration >20 years


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High cardiovascular risk

DM with a diabetes duration >10 years without end organ damage, but with an additional risk factor


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Moderate cardiovascular risk

Young patients (type 1 diabetes <35 years; type 2 diabetes

<50 years) with a diabetes duration <10 years without other risk factors


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Further risk stratification

In addition to diagnostics for the above-mentioned risk stratification, patients with diabetes and hypertension or clinical suspicion of cardiovascular disease should receive a resting ECG. At present, no convincing data exist to use additional imaging techniques such as echocardiography, stress echocardiography, scintigraphy or MRI in asymptomatic patients with diabetes mellitus. As part of clinical routines, no determination of circulating biomarkers should be carried out as part of risk stratification.


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