23. Recommendations for Patients With Diabetes Mellitus

Class IIa

1. 
   In asymptomatic adults with diabetes, 40 years of age and older, measurement of CAC is reasonable for cardiovascular risk assessment. (Level of Evidence: B)
   

Class IIb

1. 
   Measurement of hemoglobin A1C may be considered for cardiovascular risk assessment in asymptomatic adults with diabetes. (Level of Evidence: B)
   
2. 
   Stress MPI may be considered for advanced cardiovascular risk assessment in asymptomatic adults with diabetes or when previous risk assessment testing suggests a high risk of CHD, such as a CAC score of 400 or greater. (Level of Evidence: C)