Table 3. Comprehensive Diabetes Care Treatment Goals (cont'd)
Parameter
Treatment Goal
Anticoagulant Therapy
Aspirin
a
Evidence Grade
Reduce weight by at least 5%-10%;
avoid weight gain
Weight
Weight loss
D-4
For secondary CVD prevention or
primary prevention for patients at
very high riska
B-2
High risk = DM without CVD; highest risk = DM plus CVD
Table 4. Blood Pressure Goals and Treatment
Systolic mmHg
Diastolic mmHg
Treatment
< 130
< 80
Goal: continue current therapy
130-139
80-89
≥ 140
≥ 90
Lifestyle/behavioral/diet alone (max 3 months)
If target not achieved, initiate drug therapy
Lifestyle/behavioral/diet + drug therapy
Table 5. AACE Healthful Eating Recommendations for
Patients with Diabetes Mellitus
Topic
Recommendation
General eating >> Regular meals and snacks; avoid fasting to lose weight
>> Plant-based diet (high in fiber, low calories/glycemic index, and high
habits
in phytochemicals/antioxidants)
>> Understand Nutrition Facts Label information
>> Incorporate beliefs and culture into discussions
>> Informal physician-patient discussions
>> Use mild cooking techniques instead of high-heat cooking
Carbohydrate >> Explain the 3 types of carbohydrates: sugars, starch, and fiber and the
effects on health for each type
>> Specify healthful carbohydrates (fresh fruits and vegetables, pulses,
whole grains); target 7-10 servings per day
>> Lower-glycemic index foods may facilitate glycemic control (glycemic
index score < 55 out of 100: multigrain bread, pumpernickel
bread, whole oats, legumes, apple, lentils, chickpeas, mango, yams,
brown rice), but there is insufficient evidence to support a formal
recommendation to educate patients that sugars have both positive and
negative health effects
>> Specify healthful fats (low mercury/contaminant-containing nuts,
Fat
avocado, certain plant oils, fish)
>> Limit saturated fats (butter, fatty red meats, tropical plant oils, fast
foods) and trans fat; no- or low-fat dairy products
>> Consume protein in foods preferably with low saturated fats (fish, egg
Protein
whites, beans); there is no need to avoid animal protein
>> Avoid or limit processed meats
Micronutrients >> Routine supplementation is not necessary
>> Specifically: chromium, vanadium, magnesium, vitamins A, C, and E,
and CoQ10 are not recommended for glycemic control
>> Supplementation to avoid insufficiency or deficiency in at-risk patients
>> A healthful eating meal plan can generally provide sufficient micronutrients
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