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 | ||||||