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Achievement of cardiovascular risk factor targets in young adults with diabetes mellitus

BACKGROUND: Many patients with diabetes mellitus fail to achieve treatment targets recommended in recognized guidelines. Little data is available in this area relating to young adults. OBJECTIVE: To assess whether treatment goals for glycosylated hemoglobin (HbA(1c)), blood pressure, lipid-lowering,...

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Autores principales: Donovan, Peter J, McIntyre, H David
Formato: Texto
Lenguaje:English
Publicado: Dove Medical Press 2010
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3047960/
https://www.ncbi.nlm.nih.gov/pubmed/21437108
http://dx.doi.org/10.2147/DMSOTT.S13791
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author Donovan, Peter J
McIntyre, H David
author_facet Donovan, Peter J
McIntyre, H David
author_sort Donovan, Peter J
collection PubMed
description BACKGROUND: Many patients with diabetes mellitus fail to achieve treatment targets recommended in recognized guidelines. Little data is available in this area relating to young adults. OBJECTIVE: To assess whether treatment goals for glycosylated hemoglobin (HbA(1c)), blood pressure, lipid-lowering, and process outcomes for microvascular screening are being achieved in young adults with diabetes mellitus. METHODS: A retrospective clinical record audit of 202 consecutive patients with type 1 and type 2 diabetes, aged predominantly 18–45 years, attending a specialist diabetes center in Brisbane, Australia, was conducted. Assessment was made as to whether goals for HbA(1c), blood pressure, lipid lowering, and microvascular screening were being achieved. Descriptive statistics and comparison of continuous variables were produced. RESULTS: Mean (SD) HbA(1c) was 8.30% (±1.5) with no statistical difference between patients with type 1 and type 2 diabetes (P = 0.44). Sixteen percent of patients (12% type 1, 31% type 2) had an HbA(1c) of < 7%. Eighty-three percent of patients had blood pressure ≤130/80 mmHg. Sixteen percent of patients with type 1 and 37% with type 2 diabetes were achieving combined lipid targets. Only 34% and 9% of patients who had an indication (and no documented contraindication) for lipid-lowering and antiplatelet therapy, respectively, were prescribed such agents. There was a significant difference in achievement of macrovascular treatment targets in patients with type 1 and type 2 diabetes, but no difference in screening or treatment outcomes in microvascular disease. Patients below the age of 25 years were less likely to achieve macrovascular treatment targets. CONCLUSION: A large number of young adult patients with diabetes mellitus do not achieve recognized treatment targets. There appears to be less emphasis placed on macrovascular risk factor targets compared with previous audits in older patients, in patients with type 1 diabetes compared with type 2 diabetes and in patients younger than 25 years.
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spelling pubmed-30479602011-03-23 Achievement of cardiovascular risk factor targets in young adults with diabetes mellitus Donovan, Peter J McIntyre, H David Diabetes Metab Syndr Obes Original Research BACKGROUND: Many patients with diabetes mellitus fail to achieve treatment targets recommended in recognized guidelines. Little data is available in this area relating to young adults. OBJECTIVE: To assess whether treatment goals for glycosylated hemoglobin (HbA(1c)), blood pressure, lipid-lowering, and process outcomes for microvascular screening are being achieved in young adults with diabetes mellitus. METHODS: A retrospective clinical record audit of 202 consecutive patients with type 1 and type 2 diabetes, aged predominantly 18–45 years, attending a specialist diabetes center in Brisbane, Australia, was conducted. Assessment was made as to whether goals for HbA(1c), blood pressure, lipid lowering, and microvascular screening were being achieved. Descriptive statistics and comparison of continuous variables were produced. RESULTS: Mean (SD) HbA(1c) was 8.30% (±1.5) with no statistical difference between patients with type 1 and type 2 diabetes (P = 0.44). Sixteen percent of patients (12% type 1, 31% type 2) had an HbA(1c) of < 7%. Eighty-three percent of patients had blood pressure ≤130/80 mmHg. Sixteen percent of patients with type 1 and 37% with type 2 diabetes were achieving combined lipid targets. Only 34% and 9% of patients who had an indication (and no documented contraindication) for lipid-lowering and antiplatelet therapy, respectively, were prescribed such agents. There was a significant difference in achievement of macrovascular treatment targets in patients with type 1 and type 2 diabetes, but no difference in screening or treatment outcomes in microvascular disease. Patients below the age of 25 years were less likely to achieve macrovascular treatment targets. CONCLUSION: A large number of young adult patients with diabetes mellitus do not achieve recognized treatment targets. There appears to be less emphasis placed on macrovascular risk factor targets compared with previous audits in older patients, in patients with type 1 diabetes compared with type 2 diabetes and in patients younger than 25 years. Dove Medical Press 2010-11-16 /pmc/articles/PMC3047960/ /pubmed/21437108 http://dx.doi.org/10.2147/DMSOTT.S13791 Text en © 2010 Donovan and McIntyre, publisher and licensee Dove Medical Press Ltd. This is an Open Access article which permits unrestricted noncommercial use, provided the original work is properly cited.
spellingShingle Original Research
Donovan, Peter J
McIntyre, H David
Achievement of cardiovascular risk factor targets in young adults with diabetes mellitus
title Achievement of cardiovascular risk factor targets in young adults with diabetes mellitus
title_full Achievement of cardiovascular risk factor targets in young adults with diabetes mellitus
title_fullStr Achievement of cardiovascular risk factor targets in young adults with diabetes mellitus
title_full_unstemmed Achievement of cardiovascular risk factor targets in young adults with diabetes mellitus
title_short Achievement of cardiovascular risk factor targets in young adults with diabetes mellitus
title_sort achievement of cardiovascular risk factor targets in young adults with diabetes mellitus
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3047960/
https://www.ncbi.nlm.nih.gov/pubmed/21437108
http://dx.doi.org/10.2147/DMSOTT.S13791
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