Cardiovascular risk factors in patients with type 2 diabetes -: Do we follow the guidelines?

Objective: To assess the degree of control of modifiable cardiovascular risk factors (CRFs) in type 2 diabetic patients. Study design and methods: Cross-sectional study in 501 patients with type 2 diabetes mellitus. The following parameters were used to define optimal control: glycated haemoglobin (HbA(1c)) <7.0%, fasting plasma glucose (FPG) <7.2 mmol/l, postprandial capillary glucose (PCG) <10.0mmol/l, high-density lipoprotein cholesterol (HDL-C) >1,1 mmol/l, low-density lipoprotein cholesterol (LDL-C) <2.6 mmol/l, triglyceride levels (TG) < 1.7 mmol/l, systolic blood pressure (SBP) < 130 mmHg, diastolic blood pressure (DBP) <80 mmHg, body mass index (BMI) <25kg/m(2), waist circumference (WC) <88cm in women and < 102 cm in men, and current non-smoking status. The use of various cardioprotective medications was also evaluated. Results: Mean ( +/-S.D.) age was 65.4 +/- 11.9 years, 218 (44%) were male. Ninety-six (19%) met coronary artery disease (CAD). Two hundred seven patients (41%) had an HbA(1c) <7.0%, 134 (27%) a FPG <7.2 mmol/l and 231 of 353 (65%) a PCG < 10.0 mmol/l. Only 206 (41%) achieved an LDL-C <2.6 mmol/l, but 370 (74%) and 308 (62%) reached an HDL-C > 1.1 mmol/l and a TG levels < 1.7 mmol/l, respectively. In 359 (72%) patients DBP was < 80 mmHg, but in only 136 (27%) was SBP < 130 mm-Hg. Sixty four (13%) achieved a BMI <25 kg/m(2), and 420 (84%) were non-smokers. Forty three (15%) women and 104 (48%) men had a WC <88 or <102 cm, respectively. None of the patients had optimal control of all CRFs. Conclusions: These data demonstrate poor control of modifiable CRFs in the population studied, and support the need for great effort to achieve the recommended goals. (C) 2004 Elsevier Ireland Ltd. All rights reserved.