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[Prevalence and therapy of vascular risk factors in hospitalized type 2 diabetic patients]
1Medizinische Klinik Kantonsspital CH-6000 Luzern 16. Christoph.Henzen@ksl.ch
Insights
Type 2 diabetes patients have high rates of cardiovascular risk factors like hypertension and dyslipidemia. Effective management requires combined treatments to reduce complications and mortality.
Area of Science:
- Cardiology
- Endocrinology
- Public Health
Context:
- Type 2 diabetes mellitus (T2DM) significantly increases cardiovascular disease (CVD) risk.
- Managing hyperglycaemia, dyslipidaemia, and hypertension is crucial for reducing T2DM complications.
Purpose:
- To determine the prevalence and treatment of cardiovascular risk factors in type 2 diabetic patients.
- To assess the management strategies and in-hospital outcomes for T2DM patients with comorbidities.
Summary:
- A prospective cohort study analyzed 356 T2DM patients, finding high prevalence of hypertension (54%), albuminuria (53%), and dyslipidaemia (47%).
- Mean HbA1c was 7.7%, systolic blood pressure 144 mmHg, and triglycerides 2.6 mmol/l on admission. Treatment included antihypertensives, statins, aspirin, and various anti-diabetic medications.
- In-hospital mortality was 11%, with patients discharged on an average of 2.9 medications, highlighting the complexity of managing T2DM with cardiovascular risk factors.
Impact:
- The study underscores the high prevalence of cardiovascular risk factors in T2DM, necessitating combination therapies.
- Findings indicate a need for improved management protocols to decrease high admission and in-hospital mortality rates in T2DM patients.
Abstract:
Type 2 diabetes mellitus is often associated with other risk factors for atherosclerotic disease, resulting in a marked increase in cardiovascular events and deaths. Combined treatment of hyperglycaemia, dyslipidaemia and hypertension significantly decreases the frequency and severity of diabetic microvascular and macrovascular complications. In a prospective cohort study including 356 type 2 diabetic patients (= 14% of all in-patients during a 6 months' period) the prevalence and treatment of cardiovascular risk factors were determined. Hypertension was diagnosed in 54% of the diabetic patients, albuminuria in 53% and dyslipidaemia in 47%; there were 40 smokers (17%). On admission the mean HbA1c was 7.7 +/- 2.0%, the mean fasting plasma glucose 10.0 +/- 4.2 mmol/l (and 8.9 +/- 3.9 mmol/l, p = 0.03, when discharged), the mean systolic blood pressure was 144 +/- 28 mm Hg (and 131 +/- 20, p < 0.0001, when discharged), and the triglycerides were 2.6 +/- 0.4 mmol/l. 34% of the hypertensive diabetic patients were treated with a combination of anti-hypertensive drugs, 44% of the dyslipidaemic diabetic patients were treated with statins, and 58% of all diabetic patients received aspirin or oral anticoagulation. 23% of the diabetic patients were treated by diet alone, 36% with insulin, 25% with sulfonylureas and 5% with metformin, while 11% were given a combination of antihyperglycaemic medication. In-hospital mortality was 11%. The diabetic patients were discharged on 2.9 +/- 1.7 different drugs. The prevalence of associated cardiovascular risk factors is high in type 2 diabetic patients, and thus a combination of drugs is often warranted. The rate of admissions and in-hospital mortality is high in type 2 diabetic patients.