Diabetes: cardiovascular risk and cardioprotective therapy

Assigns the 2023 ESC cardiovascular risk category in diabetes from established ASCVD, severe target-organ damage (eGFR, albuminuria, microvascular disease) or the SCORE2-Diabetes estimate. Recommends cardiorenal-protective glucose-lowering drugs regardless of HbA1c. With kidney disease it follows the 2026 ESC CVD–CKD guideline: RAS inhibitor plus SGLT2 inhibitor, finerenone and semaglutide for albuminuria, an SBP target of 120–129 mmHg and yearly eGFR and UACR checks. It also covers drugs to avoid in heart failure, and LDL-C, blood-pressure, HbA1c and aspirin decisions. ESC recommendations are shown beside ACC/AHA and ADA.

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Diabetes

Age

years

HbA1c

SCORE2-Diabetes

% 10-y

Type 2 diabetes, age 40–69, without ASCVD or severe target-organ damage

Cardiovascular and kidney disease

Any of these overrides the risk score

eGFR

mL/min/1.73m²

UACR

mg/g

mg/mmol × 8.84 = mg/g

Risk factors

LDL-C

mg/dL

mmol/L × 38.67 = mg/dLSystolic BP

mmHg

Diabetes · ESC risk category (kidney care ESC 2026)

Select comorbidities or enter values.

References