Cardiovascular risk factor management in patients with diabetes: Does management differ with disease duration?
| Autor: | Peter Lin, Shaun G. Goodman, Jean-Marie Ekoé, Mary Tan, Lawrence A. Leiter, Anatoly Langer, Lianne Goldin, Samantha Lo, Jean-François Yale, Stewart B. Harris, Andrew T. Yan |
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| Rok vydání: | 2021 |
| Předmět: |
Blood Glucose
medicine.medical_specialty Time Factors Endocrinology Diabetes and Metabolism Psychological intervention Glycemic Control Primary care chemistry.chemical_compound Endocrinology Internal medicine Diabetes mellitus Internal Medicine medicine Humans Risk factor Antihypertensive Agents Glycemic Glycated Hemoglobin business.industry Type 2 Diabetes Mellitus Cholesterol LDL medicine.disease Blood pressure Diabetes Mellitus Type 2 chemistry Cardiovascular Diseases Heart Disease Risk Factors Glycated hemoglobin business |
| Zdroj: | Journal of Diabetes and its Complications. 35:107997 |
| ISSN: | 1056-8727 |
| DOI: | 10.1016/j.jdiacomp.2021.107997 |
| Popis: | Our objective was to examine risk factor modification targets and treatment in relation to duration of diabetes.The Diabetes Mellitus Status in Canada (DM-SCAN) study collected data on 5109 patients with type 2 diabetes mellitus (T2DM) in 2012 in primary care. We compared the prevalence of vascular complications, treatment targets, and interventions between patients with diagnosed diabetes duration ≤10 and 10 years.Physicians more frequently assigned HbA1c (glycated hemoglobin) targets of 7.1-8.5% (54-69 mmol/mol) to patients with longer duration of diabetes (n = 1647) (19.8% vs 9.5%, p 0.001). Patients with longer duration of diabetes were less likely to achieve HbA1c targets of ≤7.0% (53 mmol/mol) (39% vs. 55%, p 0.001), had similar likelihood of achieving blood pressure targets of ≤130/80 mmHg (38% vs. 36%, p = 0.26) and were more likely to achieve LDL-C targets of ≤2.0 mmol/L (≤77.3 mg/dL) (63% vs. 53%, p 0.001) compared to patients with shorter duration of diabetes (n = 3462). Achievement of all three targets between both groups were similar (13% vs. 13%, p = 0.82). Overall, patients with longer duration of diabetes were more likely to be prescribed anti-hyperglycemic, anti-hypertensive, lipid-lowering medications and referred for diabetes education.Only 13% of patients achieved glycemic, blood pressure, and LDL-C targets irrespective of duration of diabetes. Despite being managed with more medications, patients with longer duration of diabetes were less likely to achieve glycemic targets. More focus is needed on developing methods to bridge best care and real-world practice. |
| Databáze: | OpenAIRE |
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