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

Peter J Donovan, H David McIntyreDepartment of Endocrinology, Mater Health Services, Mater Clinical School, The University of Queensland School of Medicine, South Brisbane, QLD, AustraliaBackground: Many patients with diabetes mellitus fail to achieve treatment targets recommended in recognized guid...

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Autor principal:	McIntyre HD
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2010
Materias:	Diabetes mellitus complications vascular risk hypertension cholesterol glycated hemoglobin Specialties of internal medicine RC581-951
Acceso en línea:	https://doaj.org/article/5ea42935baa0467dad710af210249c0d
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spelling	oai:doaj.org-article:5ea42935baa0467dad710af210249c0d2021-12-02T05:53:06ZAchievement of cardiovascular risk factor targets in young adults with diabetes mellitus1178-7007https://doaj.org/article/5ea42935baa0467dad710af210249c0d2010-11-01T00:00:00Zhttps://www.dovepress.com/achievement-of-cardiovascular-risk-factor-targets-in-young-adults-with-peer-reviewed-article-DMSOhttps://doaj.org/toc/1178-7007Peter J Donovan, H David McIntyreDepartment of Endocrinology, Mater Health Services, Mater Clinical School, The University of Queensland School of Medicine, South Brisbane, QLD, AustraliaBackground: 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 (HbA1c), 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 HbA1c, blood pressure, lipid lowering, and microvascular screening were being achieved. Descriptive statistics and comparison of continuous variables were produced.Results: Mean (SD) HbA1c 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 HbA1c 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.Keywords: diabetes mellitus, complications, vascular risk, hypertension, cholesterol, glycated hemoglobinMcIntyre HDDove Medical PressarticleDiabetes mellituscomplicationsvascular riskhypertensioncholesterolglycated hemoglobinSpecialties of internal medicineRC581-951ENDiabetes, Metabolic Syndrome and Obesity: Targets and Therapy, Vol Volume 3, Pp 387-394 (2010)
institution	DOAJ
collection	DOAJ
language	EN
topic	Diabetes mellitus complications vascular risk hypertension cholesterol glycated hemoglobin Specialties of internal medicine RC581-951
spellingShingle	Diabetes mellitus complications vascular risk hypertension cholesterol glycated hemoglobin Specialties of internal medicine RC581-951 McIntyre HD Achievement of cardiovascular risk factor targets in young adults with diabetes mellitus
description	Peter J Donovan, H David McIntyreDepartment of Endocrinology, Mater Health Services, Mater Clinical School, The University of Queensland School of Medicine, South Brisbane, QLD, AustraliaBackground: 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 (HbA1c), 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 HbA1c, blood pressure, lipid lowering, and microvascular screening were being achieved. Descriptive statistics and comparison of continuous variables were produced.Results: Mean (SD) HbA1c 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 HbA1c 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.Keywords: diabetes mellitus, complications, vascular risk, hypertension, cholesterol, glycated hemoglobin
format	article
author	McIntyre HD
author_facet	McIntyre HD
author_sort	McIntyre HD
title	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_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_sort	achievement of cardiovascular risk factor targets in young adults with diabetes mellitus
publisher	Dove Medical Press
publishDate	2010
url	https://doaj.org/article/5ea42935baa0467dad710af210249c0d
work_keys_str_mv	AT mcintyrehd achievementofcardiovascularriskfactortargetsinyoungadultswithdiabetesmellitus
_version_	1718400174032683008

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

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