Only 1 in 5 adults with diabetes achieved control over
multiple risk factor targets for atherosclerotic cardiovascular disease (ASCVD),
according to United States registry data published in the journal, Diabetes,
Obesity and Metabolism.
The study examined Diabetes Collaborative Registry data from
74 393 patients with diabetes from 174 practices and 646 office locations. Of
these patients, 88% were white, 41% were women, and the average age was 69.
Patients’ average body mass index was 32 kg/m2, almost 70% had prior ASCVD, and
approximately 14% were current smokers.
Investigators found that 73.6% of patients met individual haemoglobin
A1c targets, 69% met blood pressure targets, 48.6% met low-density
lipoprotein cholesterol targets, and 85.2% were nonsmokers. However, only
21.6% of all patients achieved composite control of all 4 risk factors (P<.001). Overall risk factor control rates were lower in women (18.6%) compared with men (23.6%) and in patients who were black (14.7%), white (22.5%), and of other ethnicities (20.8%). Significant differences in rates were observed between patients with (20.7%) and without (23.6%) prior ASCVD.
The study investigators noted limitations to the Diabetes
Collaborative Registry, including that the majority of data was collected from
white patients and from a high number of cardiology practices, which may limit
generalisability of the results to all patients with diabetes.
Pointing to studies suggesting a >50% lower risk for
ASCVD in patients with diabetes who achieved multiple risk factor targets, the
investigators stated that “mproved multifactorial interventions focused
both on lifestyle management and evidence-based therapies to achieve all
targets will be necessary to optimise the prevention of future cardiovascular
Reference: Fan W,
et al. Composite cardiovascular risk factor target achievement and its
predictors in US adults with diabetes: The Diabetes Collaborative. Diabetes Obesity and Metabolism.
Published online 4 January 2019.