Multifactorial control and treatment intensity of type-2 diabetes in primary care settings in Catalonia

Cardiovascular Diabetology

Original Investigation

Sandra Bonet¹  Pilar Roura²  Lucas Mengual²  Marta Serra³  Montserrat Montasell⁴  Gemma Prieto⁵ 

[1] Adknoma Health Research, Barcelona, Spain;Health Care Centre Badia del Vallès, Badia del Vallès, Barcelona, Spain;Health Care Centre Ca n'Oriac, Sabadell, Barcelona, Spain;Health Care Centre Rosa dels Vents, Barberà del Vallès, Barcelona, Spain;Unitat de Suport a la Recerca, Ámbito Centro, Barcelona, Spain;

关键词: Waist Circumference;    Cardiovascular Risk Factor;    Target Organ Damage;    Primary Care Centre;    Good Blood Pressure Control;   

DOI  :  10.1186/1475-2840-9-14

 received in 2009-09-21, accepted in 2010-03-29,  发布年份 2010

来源: Springer

【 摘 要 】

BackgroundMany studies on diabetes have demonstrated that an intensive control of glycaemia and the main associated risk factors (hypertension, dislipidaemia, obesity and smoking) reduce cardiovascular morbi-mortality. Different scientific societies have proposed a multifactorial approach to type 2 diabetes.The objective of this study was to identify the degree of control of glycosylated haemoglobin (HbA1c) and of cardiovascular risk factors in type 2 diabetic patients, using the GedapS 2004 guidelines, and to analyse the type and intensity of drug treatment.MethodsThis cross-sectional, multicentre, epidemiological study was conducted in a primary care setting in Vallès Occidental South, Catalonia. Data were collected of 393 patients aged 18 and above who were diagnosed with diabetes mellitus type 2. Biodemographic and clinical data, cardiovascular risk factors, associated cardiovascular disease, and treatment were assessed. Descriptive and multivariable analysis with logistic regression was realized.ResultsA total of 392 patients with a mean age of 66.8 years (SD = 10.6) (45.4% male patients) were analyzed. The duration of diabetes was 8.4 years (SD = 7.6). The degree of multifactorial control of risk factors was only 2.6%, although in more than 50% individual cardiovascular risk factor was controlled, except for LDL cholesterol (40.6%) and systolic blood pressure (29.6%). Furthermore, only 13.0% of subjects had an optimal BMI, 27.5% an optimal waist circumference. Treatment for diabetes was prescribed in 82.7% of patients, for hypertension 70.7%, for dyslipidaemia 47.2% and 40.1% were taking antiplatelets.ConclusionOver 50% of type 2 diabetic patients presented optimal control of the majority of individual cardiovascular risk factors, although the degree of multifactorial control of diabetes was insufficient (2.6%) and should be improved. Drug treatment can be intensified using a larger number of combinations, particularly in patients with target organ damage and associated clinical cardiovascular disease.

【 授权许可】

Unknown   
© Mengual et al; licensee BioMed Central Ltd. 2010. This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.