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The latest European Society of Cardiology guidelines on diabetes, pre-diabetes and cardiovascular diseases recognise that considerable emerging evidence should have implications for daily clinical practice. Controversially, metformin is no longer recommended as first-line treatment in type 2 diabetes. Suggestions for the prevention of cardiovascular disease, advice on lifestyle intervention, new lipid and blood pressure targets, a novel approach to glucose-lowering treatment, diabetes treatment aimed at reducing heart failure risk, and cardiovascular risk management are included. The guidance has been developed in collaboration with the European Association for the Study of Diabetes and updates recommendations made in 2013.
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