Cardiovascular risk factors in patients with type 2 diabetes: Do we follow the guidelines?

Objective: To assess the degree of control of modifiable cardiovascular risk factors (CRFs) in type 2 diabetic patients. Study design and methods: Cross-sectional study in 501 patients with type 2 diabetes mellitus. The following parameters were used to define optimal control: glycated haemoglobin (HbA1C) <7.0%, fasting plasma glucose (FPG) <7.2mmol/l, postprandial capillary glucose (PCG) <10.0mmol/l, high-density lipoprotein cholesterol (HDL-C) >1.1mmol/l, low-density lipoprotein cholesterol (LDL-C) <2.6mmol/l, triglyceride levels (TG) <1.7mmol/l, systolic blood pressure (SBP) <130mmHg, diastolic blood pressure (DBP) <80mmHg, body mass index (BMI) <25kg/m2, waist circumference (WC) <88cm in women and <102cm in men, and current non-smoking status. The use of various cardioprotective medications was also evaluated. Results: Mean (±S.D.) age was 65.4±11.9 years, 218 (44%) were male. Ninety-six (19%) met coronary artery disease (CAD). Two hundred seven patients (41%) had an HbA1C <7.0%, 134 (27%) a FPG <7.2mmol/l and 231 of 353 (65%) a PCG <10.0mmol/l. Only 206 (41%) achieved an LDL-C <2.6mmol/l, but 370 (74%) and 308 (62%) reached an HDL-C >1.1mmol/l and a TG levels <1.7mmol/l, respectively. In 359 (72%) patients DBP was <80mmHg, but in only 136 (27%) was SBP <130mmHg. Sixty four (13%) achieved a BMI <25kg/m2, and 420 (84%) were non-smokers. Forty three (15%) women and 104 (48%) men had a WC <88 or <102cm, respectively. None of the patients had optimal control of all CRFs. Conclusions: These data demonstrate poor control of modifiable CRFs in the population studied, and support the need for great effort to achieve the recommended goals.