Reducing cardiovascular disease risk in patients with type 2 diabetes: a message from the National Diabetes Education Program (original) (raw)
Related papers
Challenges in preventing cardiovascular complications in type 2 diabetes in primary care
European Journal of General Practice, 2005
Background: Prevalence of type 2 diabetes mellitus (DM2) continues to increase worldwide. The associated cardiovascular morbidity and mortality are high. Objectives: To study daily practice in preventing cardiovascular disease (CVD) in an unselected primary care patient population with DM2, and to study factors influencing the care delivered. Methods: Cross-sectional univariate and multivariate analyses of baseline data from a primary care population-based sample of patients with DM2, participating in a shared care project in the Netherlands. Results: Of 1269 patients invited, 1149 (91%) participated. Hypertension was present in 78% of patients, 63% of whom were treated, 41% successfully. Lipid profile abnormalities were present in 5 1 % of patients, 22% of whom were treated, 54% successfully. The treatment rates for lipid profile abnormalities were positively correlated with younger age and the registration of the lipid profile by the GP. For hypertension Lielith J Ubink-Veltrnaat MD PHD, researcher, general practitioner in training Roel 0 Rischen MD, general practitioner Family practice 't Veen, Correspondence to: Lielith J Ubink-Veltmaat the treatment rates were higher for patients who were female, of an advanced age, in the presence of CVD, andlor whose blood pressure had been registered by the GP. Conclusion: A gap exists between recommended care and the care patients actually receive in the prevention of CVD in patients with DM2 in the primary care setting. Diagnosed CVD and the accurate registration of cardiovascular risk factors by GPs are associated with higher treatment rates. Improvement strategies could be directed at primary prevention of CVD and improving the registration of cardiovascular risk factors. EurJ Gen Prud 2005;ll:ll-6.
Primary prevention of cardiovascular events and type 2 diabetes
Diabetes & Metabolism, 2006
The diagnosis of type 2 diabetes is based on elevated blood glucose levels. However, in most individuals, metabolic abnormalities as well as cardiovascular risk factors co-exist with a significant proportion of patients presenting with elevated blood pressure, high triglycerides and decreased HDL-cholesterol in addition to hyperglycemia. The risk of cardiovascular disease in people with type 2 diabetes is very high as cardiovascular death represents the number 1 killer in this population. An integrated approach controlling all risk factors as well as blood glucose has been demonstrated to effectively reduce the risk of cardiovascular complications. However, this requires the administration of multiple medications and some patients will have difficulties adhering to the prescribed regimen, limiting the number of drugs the physician can prescribe. In this review, we will summarize the efficacy of different approaches in primary prevention to help practitioners prioritize interventions in these situations.
Prevention of Cardiovascular Risk in Diabetic Patients – An Update
European Endocrinology, 2007
Patients with type 2 diabetes have a well-documented increased risk of cardiovascular disease (CVD) that is more than two to three times higher than the risk seen in non-diabetic subjects. 1 In spite of modern methods to treat diabetes and its complications, the increased risk is still substantial even if data on risk factor controls in national surveys have shown improving trends for blood pressure and lipid control, for example from Sweden. 2 The most important CVD risk factors to detect, treat and make follow-up visits for are elevated blood-pressure levels, dyslipidaemia and elevated low-density lipoprotein (LDL) cholesterol, as well as
The American Journal of Cardiology, 2007
Patients with type 2 diabetes mellitus die of cardiovascular disease (CVD) at rates 2-4 times higher than patients without diabetes but with similar demographic characteristics. The prevalence of diabetes is increasing in the United States and, thus, the prevention of CVD in patients with diabetes poses an urgent public health challenge. The objective of this report is to review the current knowledge base for the prevention of CVD in patients with diabetes, with particular emphasis on the control of glycemia, lipids, and blood pressure. Epidemiologic analyses suggest that each 1% increase in glycosylated hemoglobin increases the risk for CVD by approximately 18%; however, evidence from the randomized trials that have examined whether glucose lowering reduces this risk is conflicting. Randomized trials have shown that lowering low-density lipoprotein cholesterol reduces CVD event rates by 17%-43% in patients with diabetes. Limited data support a role for lowering triglycerides and increasing high-density lipoprotein cholesterol in the prevention of CVD. Evidence from clinical trials shows that reducing systolic blood pressure to <140 mm Hg results in 30%-60% reductions in CVD events; however, epidemiologic evidence suggests that lowering to optimal systolic blood pressure levels (<120 mm Hg) may be additionally beneficial.
Current Diabetes Reviews, 2021
Introduction: Patients with type 2 diabetes mellitus (T2DM) are at significantly higher risk of developing cardiovascular diseases (CVD). There is a scarcity of literature reviews that describe and summarize T2DM patients' knowledge and perception about CVD prevention. Objectives: To describe and summarize the assessment of knowledge and perceptions about CVD risk and preventive approaches among patients with T2DM. Methods: A scoping review methodology was adopted, and three scientific databases, Google Scholar, Science Direct, and PubMed were searched using predefined search terms. A multistage screening process that considered relevancy, publication year (2009-2019), English language, and article type (original research) was followed. We formulated research questions focused on the assessment of levels of knowledge and perceptions of the illness relevant to CVD prevention and the identification of associated patients' characteristics. Results: A total of 16 studies were in...
Reducing the burden of diabetes: managing cardiovascular disease
Diabetes/Metabolism Research and Reviews, 1999
Of the threats to health and life that beset the person with diabetes, cardiovascular disease (CVD), particularly coronary heart disease (CHD) but also cerebrovascular and peripheral vascular disease, represent the heaviest burden. The relative risk for CVD is very high for Type 1 diabetes, but the absolute risk, in terms of numbers, is much higher for Type 2. In all societies, diabetes increases cardiovascular risk twofold or more, compared with the local non-diabetic population. Some of the evidence for this diabetes-related increase in cardiovascular risk is reviewed and its relationship to recognised cardiovascular risk factors considered. The explanation of the enhanced susceptibility to atherosclerotic disease in diabetes remains a matter of contention. How much can be explained by greater prevalence in diabetes of such risk factors as hypertension and dyslipidaemia? To what extent is the impact of a given level of risk factor magni®ed by a co-existing diabetic state? Is the increased cardiovascular morbidity and mortality secondary to risk factors speci®cally related to the diabetic state itself? Does the explanation lie in altered coagulability due to changes in platelet activation and aggregability, ®brinogen levels, Factor VII, von Willebrand factor or PAI-1, in the concentration or composition of plasma lipoproteins, in defective endothelial cell function or other metabolic abnormalities of the arterial wall? To what extent is cardiovascular risk related to the degree of hyperglycaemia, protein glycation, relative hyperinsulinaemia and insulin resistance? Data from recent epidemiological, intervention and laboratory investigations bearing on causation, management and prevention of CVD in diabetes are reviewed. Evidence for the impact of correction of glycaemia, dyslipidaemia and raised arterial pressure is considered and reasons are adduced for a broad and proactive therapeutic approach with early identi®cation and vigorous correction of key risk factors.
Pharmacological Strategies to Reduce Cardiovascular Risk in Type 2 Diabetes Mellitus
Drugs, 2005
Abstract dominated by the occurrence of cardiovascular disease (CVD). Treatment of known risk factors of CVD has proven to be beneficial in terms of reduction in risk of major CVD events in the general population. Recent trials have provided information on the treatment of hyperglycaemia, hypertension, dyslipidaemia and platelet aggregation in the patient with type 2 diabetes.