This is the second iteration of the European Society of Cardiology (ESC) and European Association for the Study of Diabetes (EASD) joining forces to write guidelines on the management of diabetes mellitus (DM), pre-diabetes, and cardiovascular disease (CVD), designed to assist clinicians and other healthcare workers to make evidence-based management decisions. The growing awareness of the strong biological relationship between DM and CVD rightly prompted these two large organizations to collaborate to generate guidelines relevant to their joint interests, the first of which were published in 2007. Some assert that too many guidelines are being produced but, in this burgeoning field, five years in the development of both basic and clinical science is a long time and major trials have reported in this period, making it necessary to update the previous Guidelines.
The processes involved in generating these Guidelines have been previously described and can be found at https://www.escardio.org/guidelines-surveys/esc-guidelines/about/Pages/rules-writing.aspx. In brief, the EASD and the ESC appointed Chairs to represent each organization and to direct the activities of the Task Force. Its members were chosen for their particular areas of expertise relevant to different aspects of the guidelines, for their standing in the field, and to represent the diversity that characterizes modern Europe. Each member agreed to produce—and regularly update—conflicts of interest, the details of which are held at the European Heart House and available at the following web address: https://www.escardio.org/guidelines. Members of the Task Force generally prepared their contributions in pairs and the ESC recommendations for the development of guidelines were followed, using the standard classes of recommendation, shown below, to provide consistency to the committee's recommendations (Table 1 and Table 2).
Classes of recommendations
Levels of evidence
Initial editing and review of the manuscripts took place at the Task Force meetings, with systematic review and comments provided by the ESC Committee for Practice Guidelines and the EASD Panel for Overseeing Guidelines and Statements.
These Guidelines are the product of countless hours of hard work, time given freely and without complaint by the Task Force members, administrative staff and by the referees and supervisory committees of the two organizations. It is our hope that this huge effort has generated guidelines that will provide a greater understanding of the relationship between these two complex conditions and an accessible and useful adjunct to the clinical decision-making process that will help to provide further clarity and improvements in management.
The task of developing Guidelines covers not only the integration of the most recent research, but also the creation of educational tools and implementation programmes for the recommendations.
To implement the Guidelines, condensed pocket guidelines, summary slides, booklets with essential messages and an electronic version for digital applications (smartphones, etc.) are produced. These versions are abridged; thus, if needed, one should always refer to the full text version, which is freely available on the ESC website.
Eur Heart J. 2013;34(39):3035-3087. © 2013 Oxford University Press
Copyright 2007 European Society of Cardiology. Published by Oxford University Press. All rights reserved.