Table 1 Treatment recommendations in the intensive treatment arm
| Target | Baseline |
2 months If above target |
4 months If above target |
6 months If above target |
9 months If above Target |
12 months If above target | |
|---|---|---|---|---|---|---|---|
| HbA1c | <7.0% | Diet |
HbA1c >6.5% Metformin (avoid using metformin if creatinine level >130 μmol/L) |
HbA1c >6.5% add a second medication Metformin or PGR or SU or TZD |
HbA1c >6.5% add a third medication Metformin or PGR or SU or TZD |
Continue oral hypoglycaemic medication and consider adding insulin |
As for 9 months |
|
Blood Pressure | ≤ 135/85mmHg |
>120/80 mmHg or CVD+ ACE Inhibitor titrated to maximum dose |
If bp >135/85 mmHg Add a Thiazide diuretic or Ca Antagonist (Change ACE to ACE2 if creatinine >130 μmol/L or K+ >5.0 mmol/L or intolerable side effects) | As for 2 months |
If bp >135/85 mmHg Add β blocker orα Blocker | As for 6 months |
As for 6 months |
|
Cholesterol †IHD- | <5.0mmol/l |
Chol ≥ 3.5 mmol/l, diet & statin |
Chol >5.0 mmol/l Increase statin dose up to maximum(If CK> 1800 U/L, stop statin) | As for 2 months |
Consider adding a fibrate if Chol >5.0 mmol/l | As for 6 months |
As for 6 months |
|
Cholesterol IHD+ | <4.5mmol/l |
chol ≥ 3.5 mmol/, diet & statin |
Chol >4.5 mmol/l Increase statin dose up to maximum(If CK> 1800 U/L, stop statin) | As for 2 months |
Consider adding a fibrateif Chol >5.0 mmol/l | As for 6 months |
As for 6 months |
| Acetylsalycilic acid | 75 mg of aspirin daily to all patients without specific contraindications | ||||||