The Living Guidelines: UA/NSTEMI Recommendations for UA/NSTEMI in Diabetic Patients Suggest Revisions to the CLASS I Guidelines

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Class I Guidelines

 * 1) Medical treatment in the acute phase of UA / NSTEMI and decisions on whether to perform stress testing, angiography, and revascularization should be similar in patients with and without diabetes mellitus. (Level of Evidence: A)
 * 2) In all patients with diabetes mellitus and UA / NSTEMI, attention should be directed toward aggressive glycemic management in accordance with current standards of diabetes care endorsed by the American Diabetes Association and the American College of Endocrinology. Goals of therapy should include a pre-prandial glucose target of <110 mg/dL and a maximum daily target of <180 mg/dL. The post discharge goal of therapy should be HbA1C <7%, which should be addressed by primary care and cardiac caregivers at every visit. (Level of Evidence: B)
 * 3) An intravenous platelet GP IIb/IIIa inhibitor should be administered for patients with diabetes mellitus as recommended for all UA / NSTEMI patients. (Level of Evidence: A)
 * a. This benefit may be enhanced in patients with diabetes mellitus. (Level of Evidence: B)