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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Autores principales:	Peter J Donovan, H David McIntyre
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2010
Materias:	Specialties of internal medicine RC581-951
Acceso en línea:	https://doaj.org/article/d7b84853df4048b6af6d3f28148d7c49
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spelling	oai:doaj.org-article:d7b84853df4048b6af6d3f28148d7c492021-12-02T09:06:30ZAchievement of cardiovascular risk factor targets in young adults with diabetes mellitus1178-7007https://doaj.org/article/d7b84853df4048b6af6d3f28148d7c492010-11-01T00:00:00Zhttp://www.dovepress.com/achievement-of-cardiovascular-risk-factor-targets-in-young-adults-with-a5673https://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&ndash;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% (&plusmn;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 &lt;7%. Eighty-three percent of patients had blood pressure &le;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 Peter J DonovanH David McIntyreDove Medical PressarticleSpecialties of internal medicineRC581-951ENDiabetes, Metabolic Syndrome and Obesity: Targets and Therapy, Vol 2010, Iss default, Pp 387-394 (2010)
institution	DOAJ
collection	DOAJ
language	EN
topic	Specialties of internal medicine RC581-951
spellingShingle	Specialties of internal medicine RC581-951 Peter J Donovan H David McIntyre 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&ndash;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% (&plusmn;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 &lt;7%. Eighty-three percent of patients had blood pressure &le;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	Peter J Donovan H David McIntyre
author_facet	Peter J Donovan H David McIntyre
author_sort	Peter J Donovan
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/d7b84853df4048b6af6d3f28148d7c49
work_keys_str_mv	AT peterjdonovan achievementofcardiovascularriskfactortargetsinyoungadultswithdiabetesmellitus AT hdavidmcintyre achievementofcardiovascularriskfactortargetsinyoungadultswithdiabetesmellitus
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Achievement of cardiovascular risk factor targets in young adults with diabetes mellitus

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