Screening for silent myocardial ischemia in patients with diabetes: how to manage in 2018, waiting for next recommendations?

Screening for ischemia in asymptomatic diabetic patient should not be systematic but rather performed in a populatio selected according to the following criteria: abnormalities of basal ECG; >= 2 cardiovascular risk factors or an organ damage and high coronary artery calcium score; when physical activity is newly planned. When ischemia is identified, cardiovascular risk factors shoul be better controlled, anti-ischemic treatment optimized an coronary stenoses identified to be revascularized: by-pass i case of trivascular stenoses, angioplasty in case of coronar stenosis with downstream ischemia