Accumulation of multiple uncontrolled risk factors among individuals with type 2 diabetes: a cross-sectional study of...

To assess the prevalence of uncontrolled cardiovascular risk factors (RFs) and missing measurements among adults with type 2 diabetes (T2D) and to identify characteristics associated with poor monitoring and RF target attainment.

This registry-based cross‑sectional study of a primary care diabetes cohort used health record data of 10 420 adults with T2D from North Karelia, Finland. The most recent measurements of glycated haemoglobin (HbA1c), low density lipoprotein cholesterol (LDL-C), blood pressure (BP), body mass index (BMI) and smoking status from 2023 to 2024 were evaluated against guideline-derived, risk-profile-specific targets. Logistic regression examined associations with patient characteristics.

Missing measurements were most common for smoking, BP and BMI. Younger adults, particularly men, had the highest prevalence of missing measurements and RF target failure. More than half (56.8%) had ≥ 2 uncontrolled RFs, while 11.2% achieved all five RF targets. HbA1c, BP and BMI showed the greatest target failure. Older age and longer T2D duration were associated with better monitoring and attainment of several RF targets.

Significant gaps in RF monitoring and control persist in primary health care. Younger adults, especially men, had fewer measurements recorded and had higher multifactor target non-attainment, based on available data, highlighting the need for more structured and proactive primary care management.