Clinical Practice Guideline

Metabolic Risk Guideline Resources

July 01, 2019

Full Guideline: Primary Prevention of ASCVD and T2DM in Patients at Metabolic Risk
JCEM | September 2019 (online July 2019)

James L. Rosenzweig (Chair), George L. Bakris, Lars F. Berglund, Marie-France Hivert, Edward S. Horton, Rita R. Kalyani, M. Hassan Murad, Bruno L. Vergès

The 2019 guideline on metabolic risk:

  • Updates the previous recommendations on this topic from the 2008 guideline – particularly those on elevated lipids and blood pressure – to reflect more recent data.
  • Emphasizes measures to identify and reduce the risk of ASCVD and T2DM, rather than defining the metabolic syndrome as a clinical entity.
  • Focuses on adults between 40 and 75 years of age, for whom a higher quality of evidence exists than for other age groups, thus accruing the greatest impact.



Resources


Essential Points

  • Individuals should be screened for metabolic risk, in five categories:
    1. Elevated waist circumference
    2. Decreased HDL cholesterol
    3. Elevated serum triglycerides
    4. Elevated blood pressure
    5. Elevated blood glucose
  • Three or more categories being abnormal should alert the clinician to a patient’s increased risk for ASCVD and DM (i.e., metabolic risk).
  • We recommend that providers measure waist circumference as part of the initial evaluation. (Note, however, that this does not replace the measurement of weight.)
  • Behavioral change should be the first-line therapy for prevention and should include changes to diet, increased exercise, and weight loss.
  • Persons identified as having metabolic risk should undergo risk scoring to identify the 10-year risk for ASCVD.


List of Recommendations

+ 1.0 Definitions and Diagnosis

+ 2.0 Lifestyle and Behavioral Therapy

+ 3.0 Medical and Pharmacological Therapy

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Endocrine Society Guideline Methodologists

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We are seeking two members to undertake training to become GRADE-certified Endocrine Society Guideline Methodologists (ESGM) for the development of Endocrine Society Clinical Practice Guidelines. ESGMs will materially participate in the guideline development process and thus will be guideline authors, and will also gain valuable career development experience in the process.

We are seeking two members to undertake training to become GRADE-certified Endocrine Society Guideline Methodologists (ESGM) for the development of Endocrine Society Clinical Practice Guidelines. ESGMs will materially participate in the guideline development process and thus will be guideline authors, and will also gain valuable career development experience in the process.

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