+ Site Statistics
References:
54,258,434
Abstracts:
29,560,870
PMIDs:
28,072,757
+ Search Articles
+ PDF Full Text Service
How our service works
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ Translate
+ Recently Requested

Glycaemic control and cardiovascular risk factor management in patients with diabetes with and without coronary artery disease: insights from the diabetes mellitus status in Canada survey



Glycaemic control and cardiovascular risk factor management in patients with diabetes with and without coronary artery disease: insights from the diabetes mellitus status in Canada survey



European Heart Journal. Quality of Care and Clinical Outcomes 2(4): 277-284



Current diabetes guidelines recommend an individualized approach to glycaemic control. There are limited data on the contemporary and comprehensive management of patients with diabetes in relation to coronary artery disease (CAD). The Diabetes Mellitus Status in Canada (DM-SCAN) survey included 5123 patients with type 2 diabetes seen in primary care in November 2012. Primary care physicians (PCPs) collected clinical data and specified the A1C target for each patient on standardized forms. We compared management strategies and achievement of treatment targets in patients with and without CAD. Among the 4994 patients with data on CAD history, 22.5% had CAD. Primary care physicians were more likely to select a higher A1C target for patients with CAD (≤7.5 or ≤8.0%) versus without (≤7.0%). There was no difference in median A1C or in the proportion of patients with A1C ≤7.0% between the two groups. Compared with the group without known CAD, patients with CAD had a higher reported prevalence of hypoglycaemia in the preceding 6 months; more frequently received aspirin, statins, ACE inhibitors, or angiotensin receptor blockers, and were more likely to achieve blood pressure and low-density lipoprotein-cholesterol targets. Only 15.4 and 12.0% of patients with and without CAD (P = 0.002), respectively, achieved all three guideline-recommended targets. Compared with patients with diabetes without CAD, those with CAD more frequently had a less stringent A1C target selected by their PCPs but achieved similar glycaemic control. Overall, risk factor management remained suboptimal in both groups. There remains an important opportunity to improve the care and outcome of patients with diabetes.

Please choose payment method:






(PDF emailed within 0-6 h: $19.90)

Accession: 065178440

Download citation: RISBibTeXText

PMID: 29474711

DOI: 10.1093/ehjqcco/qcw013


Related references

Glycemic Control And Cardiovascular Risk Factor Management In Patients With Diabetes With And Without Coronary Artery Disease: Insights From The Diabetes Mellitus Status In Canada (Dm-Scan) Survey. Canadian Journal of Cardiology 30(10): S79-S80, 2014

Changes in glycaemic control and risk of coronary artery disease in type 1 diabetes mellitus: findings from the Pittsburgh Epidemiology of Diabetes Complications Study (EDC). Diabetologia 50(11): 2280-2288, 2007

Blood Pressure Management In Patients With Diabetes: Insights From The Diabetes Mellitus Status In Canada (Dm-Scan) Survey. Canadian Journal of Cardiology 31(10): S265-S266, 2015

Blood Pressure Management in Adults With Type 2 Diabetes: Insights From the Diabetes Mellitus Status in Canada (DM-SCAN) Survey. Canadian Journal of Diabetes 42(2): 130-137, 2017

Tumour necrosis factor-alpha plasma level in patients with type 1 diabetes mellitus and its association with glycaemic control and cardiovascular risk factors. Journal of Internal Medicine 248(1): 67-76, 2000

Management of coronary artery disease in patients with and without diabetes mellitus. Acute management reasonable but secondary prevention unacceptably poor: a report from the Euro Heart Survey on Diabetes and the Heart. European Journal of Cardiovascular Prevention and Rehabilitation 14(1): 28-36, 2007

Nurse-led cardiovascular risk factor intervention leads to improvements in cardiovascular risk targets and glycaemic control in people with Type 1 diabetes when compared with routine diabetes clinic attendance. Diabetic Medicine 28(3): 373-379, 2011

Glycaemic control and other cardiovascular risk factors should be targeted independently in patients with type 2 diabetes mellitus. Atherosclerosis 217(1): 297-298, 2012

Control of glycemia and other cardiovascular disease risk factors in older adults with type 2 diabetes mellitus: data from the Adult Diabetes Control and Management. Geriatrics and Gerontology International 14(1): 130-137, 2014

Age-related differences in glycaemic control, cardiovascular disease risk factors and treatment in patients with type 2 diabetes: a cross-sectional study from the Australian National Diabetes Audit. BMJ Open 8(8): E020677, 2018

Hypoglycemia in Diabetes Mellitus as a Coronary Artery Disease Risk Factor in Patients at Elevated Vascular Risk. Journal of Clinical Endocrinology and Metabolism 101(2): 659-668, 2016

Age ≥ 60 years was an independent risk factor for diabetes-related complications despite good control of cardiovascular risk factors in patients with type 2 diabetes mellitus. Experimental Gerontology 48(5): 485-491, 2013

Incidence of diabetes mellitus and risk factor management in patients undergoing coronary artery bypass grafting. Diabetes 48(Suppl. 1): A170, 1999

Effects of intensive blood pressure control in the management of patients with type 2 diabetes mellitus in the Action to Control Cardiovascular Risk in Diabetes (ACCORD) trial. Circulation 122(8): 847-849, 2010

Emerging Cardiovascular Disease Biomarkers and Incident Diabetes Mellitus Risk in Statin-Treated Patients With Coronary Artery Disease (from the Treating to New Targets [TNT] Study). American Journal of Cardiology 118(4): 494-498, 2017