Cardiovascular risk factor control in British adults with diabetes mellitus: Retrospective cohort study

Using primary care electronic medical records (the United Kingdom Health Improvement Network Database 2003‐2015), we examined the control of cardiovascular risk factors in the first year after diagnosis in British adults with diabetes mellitus. Among 292 170 individuals with diabetes receiving frequent outpatient management (median of 16 primary care visits in the prior year), control of cardiovascular risk factors a median of 354 days after diagnosis was suboptimal: 14.7% had HbA1C < 7%, SBP < 140 mm Hg, LDL cholesterol ≤1.8 mmol/L or taking a statin, and were nonsmokers (the proportion dropped to 7.5% if the SBP target was defined as <130 mm Hg). While 90.4% had an LDL cholesterol ≤1.8 mmol/L or were taking a statin, and 86.0% were nonsmokers, only 52.0% had HbA1C < 7% and 53.1% had SBP < 140 mm Hg (29.8% had SBP < 130 mm Hg) despite 71.4% taking antihypertensive agents. Thus, there is still a need for quality improvement strategies that target all atherosclerotic risk factors in individuals with diabetes and not just glycaemic control.