CONTROL OF GLYCEMIA AND CARDIOVASCULAR RISK FACTORS IN PATIENTS WITH TYPE 2 DIABETES IN PRIMARY CARE IN MONTENEGRO

Milena M. Cojić, Ljiljana Cvejanov-Kezunović, Jelena Stanković, Nebojša Kavarić, Maja Koraćević, Ljiljana Damjanović

DOI Number
https://doi.org/10.22190/FUMB180213004C
First page
016
Last page
020

Abstract


Some observational studies have shown that only a small number of diabetic patients achieve optimum control of glycaemia and cardiovascular risk factors. The aim of this study was to analyze whether patients with type 2 diabetes mellitus treated in primary care achieve adequate control of glycemic levels and cardiovascular risk factors. This was a retrospective, record-based, cross-sectional study that included eligible patients from 35 to 90 years old with type 2 diabetes mellitus treated in Primary Health Care Center in Podgorica. We investigated electronic records of 531 diabetic patients. The observed prevalence of type 2 diabetes mellitus among individuals between ages 35 and 90 years, was 11,84 %. Half of the patients were female. The mean age was 65,88±9,86 years. The mean value of HbA1c was 7,56±1,71. Fifty-nine percents of patients achieved optimal levels of HbA1c ≤ 7 %. Also, more than half of patients achieved target levels of blood pressure while 27.9% achieved LDL ≤ 2.6 mmol/L. Fifty percent of patients were non-smokers and 45.1 % were obese. Among patients on primary prevention only 5.7 % had met all target levels while on secondary prevention that number was even smaller 3.7 %. Our study showed that control of HbA1c and blood pressure was similar to other studies but reaching target levels of LDL was challenging for our patients. Further analysis are needed in order to discover the reasons for poor control of certain CVRF and to develop strategies for its optimal management.


Keywords

diabetes mellitus type 2, management, risk factors, targets

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References


Tamayo T, Resenbauer J, Wild SH, Spijkerman AM, Baan C, Forouhi NG et al. Diabetes in Europe: an update. Diabetes Res Clin Pract 2014; 103(2):206-217.

Forouhi NG, Wareham NJ. Epidemiology of diabetes. Medicine (Abingdon) 2014; 42(12):698-702.

Heydari I, Radi V, Razmjou S, Amiri A. Chronic complications of diabetes mellitus in newly diagnosed patients. Int J Diabetes Melit 2010, 2(1):61-63.

Bertoluci MC, Rocha VZ. Cardiovascular risk assessment in patients with diabetes. Diabetol Matab Syndr 2017; 9:25.

Centers for Disease Control and Prevention. National diabetes statistics report: Estimates of diabetes and its burden in the United States, 2014. Atlanta, GA: US Department of Health and Human Services; 2014.

American Diabetes Association. Standards of Medical Care in Diabetes – 2017. Diabetes Care 2017; 40(Suppl. 1):S75-S87.

Vinagare I, Mata-Cases M, Hermosilla E et al. Control of glycemia and cardiovascular risk factors in patients with type 2 diabetes in primary care in Catalonia (Spain). Diabetes Care 2012; 35(4):

-9.

American Diabetes Association. Promoting Health and Reducing Disparities in Populations. Diabetes Care 2017; 40(Suppl. 1): S6-S10.

National Kidney Foundation. GFR calculator. Available at: https://www.kidney.org/professionals/kdoqi/gfr_calculator

Piepoli MF, Hoes AW, Agewall S et al. 2016 European Guidelines on cardiovascular disease prevention in clinical practice: The Sixth Joint Task Force of the European Society of Cardiology and Other Societies on Cardiovascular Disease Prevention in Clinical Practice (constituted by representatives of 10 societies and by invited experts) Developed with the special contribution of the European Association for Cardiovascular Prevention & Rehabilitation (EACPR). Eur Heart J 2016; 37:2315–2381.

R development core team R: a language and enviroment for statistical computing. R foundation for statistical computing, Vienna, Austria, 2011.

International Diabetes Federation. IDF Diabetes Atlas, 8th edn. Brussels, Belgium: International Diabetes Federation, 2017. Availible at: http://www.diabetesatlas.org

Colosia AD, Palencia R, Khan S. Prevalence of hypertension and obesity in patients with type 2 diabetes mellitus in observational studies: a systematic literature review. Diabetes Metab Syndr Obes 2013; 6:327-38.

Martín-Timón I, Sevillano-Collantes C, Segura-Galindo A, Javier del Cañizo-Gómez F. Type 2 diabetes and cardiovascular disease: Have all risk factors the same strength? World J Diabetes 2014; 5(4):444-70.

Parati G, Ochoa JE, Salvi P, Lombardi C, Bilo G. Prognostic Value of Blood Pressure Variability and Average Blood Pressure Levels in Patients With Hypertension and Diabetes. Diabetes Care 2013; 36(Suppl 2):S312-324.

Mooradian AD. Dyslipidemia in tpe 2 diabetes mellitus. Nat Clin Pract Endocrinol Metab 2009; 5(3):150-9.

Chehade JM, Gladysz M, Mooradian AD. Dyslipidemia in type 2 diabetes: prevalence, pathophysiology, and management. Drugs 2013; 73(4):327-39.

Russo G, Pintaudi B, Giorda C et al. Age- and gender-related differences in LDL-cholesterol management in outpatients with type 2 diabetes mellitus. Int J Endocrinol 2015; 2015:957105.

Mata-Cases M, Franch-Nadal J, Real J, Maurico D. Glycaemic control and antidiabetic treatment trends in primary care centres in patients with type 2 diabetes mellitus during 2007-2013 in Catalonia: a population-based study. BMJ 2016; 6(10): e012463.

Blonde L, Aschner P, Bailey C et al. Gaps and barriers in the control of blood glucose in people with type 2 diabetes. Diab Vasc Dis Res 2017; 14 (3):172-83.

Litwak L, Goh SY, Hussein Z, Malek R, Prusty V, Khamseh ME. Prevalence of diabetes complications in people with type 2 diabetes mellitus and its association with baseline characteristics in the multinational A1chieve study. Diabetol Metab Syndr 2013;5(1):57.

Fowler M. Microvascular and Macrovascular Complications of Diabetes. Clinical Diabetes 2008; 26(2):77-82.

Ting DSW, Cheung GCM,Wong T Y. Diabetic retinopathy: global prevalence, major risk factors, screening practices and public health challenges: a review. Clinical & Experimental Ophthalmology 2016; 44:260–77.

DAI Study Group. The prevalence of coronary heart disease in Type 2 diabetic patients in Italy: the DAI study. Diabet Med 2004; 21(7): 738-45.

Corriere MD, Minang LB, Sisson SD, Brancati FL, Kalyani RR. The use of clinical guidelines highlights ongoing educational gaps in physicians' knowledge and decision making related to diabetes. BMC Med Educ 2014; 14:186.

Stark Casagrande S, Fradkin JE, Saydah SH, Rust KF, Cowie CC. The prevalence of meeting A1C, blood pressure, and LDL goals among people with diabetes 1988-2010. Diabetes Care 2013; 36(8): 2271-9.




DOI: https://doi.org/10.22190/FUMB180213004C

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