The AACE diabetes algorithm is a comprehensive management algorithm that covers lifestyle, obesity, prediabetes, lipids, hypertension and glucose management strategies. It is the most up-to-date and progressive management algorithm that now includes strategies based on all the newest cardiovascular (CV) outcome trials in diabetes and related metabolic CV outcome trials and incorporates the latest FDA indications.
Strategies included in the 2020 AACE diabetes algorithm go beyond just managing and controlling CV risk factors to preventing the next CV events - morbidity and mortality in both patients with established ASCVD and those at high risk for cardiovascular disease (CVD).
New guidance for primary and secondary prevention of CVD, strokes, congestive heart failure (CHF), chronic kidney disease (CKD), and mortality are independent of patient lipid and glucose levels, given that SGLT2 inhibitors and long-acting GLP1 receptor agonists with proven benefits may be prescribed as first line in these patients.
Additional new guidance includes:
- Management of patients who have moderate to severe CKD (e.g., an eGFR ≥30 mL/min/1.73m2) with SGLT2 inhibitors that have shown benefit, specifically canagliflozin
- Management of patients with CHF with reduced function with SGLT2i with proven benefit, specifically dapagliflozin.
- Management of patients with established or high risk for CVD who have triglyceride levels between 135-499 mg/dL with EPA with proven benefits to prevent the next event