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Composite cardiovascular risk factor target achievement and its predictors in US adults with diabetes: The Diabetes Collaborative Registry.
- Source :
-
Diabetes, obesity & metabolism [Diabetes Obes Metab] 2019 May; Vol. 21 (5), pp. 1121-1127. Date of Electronic Publication: 2019 Feb 14. - Publication Year :
- 2019
-
Abstract
- Aim: To investigate multiple risk factor target attainment in adults with diabetes mellitus (DM) for atherosclerotic cardiovascular disease (ASCVD) prevention and the predictors of such attainment in a contemporary DM registry.<br />Methods: In the US Diabetes Collaborative Registry we identified patients who were at target for glycated haemoglobin (HbA1c; < 53 mmol/mol (7%) or < 64 mmol/mol (8%) if with ASCVD), LDL cholesterol (< 2.6 mmol/L (100 mg/dL) or < 1.8 mmol/L (70 mg/dL) 1.8 if with ASCVD) and blood pressure (BP; <140/90 mmHg and < 130/80 mmHg as an alternate), and who had non-smoking status, by sex, race and history of ASCVD. Multiple logistic regression was used to examine predictors of target attainment.<br />Results: In 74 393 patients with DM who had available data (mean age 69.0 years, 41.0% women), overall target attainment for HbA1c, BP, LDL cholesterol and non-smoking status was 73.6%, 69.0% (40.3% for BP <130/80 mmHg), 48.6% and 85.2%, respectively. Only 21.6% (13.0% with BP <130/80 mmHg) were at target for all four measures, and the proportions were higher in men (23.6%) versus women (18.6%) and in white people (22.5%) versus African-American people (14.7%) and people of other races (20.8%; P < 0.01). A total of 62.4% were on a moderate-/high-intensity statin. Age (≥65 years: odds ratio [OR] 1.9, 95% confidence interval [CI] 1.7-2.0; and 55-64 years: OR 1.3, 95% CI 1.2-1.4 vs. <55 years), male sex (OR 1.3, 95% CI 1.3-1.4), white race (OR 1.4, 95% CI 1.3-1.5), middle or high income (ORs 1.1, 95% CI 1.1-1.2 or 1.4, 95% CI 1.4-1.5, respectively) were associated, and depression (OR 0.9, 95% CI 0.8-1.0) was inversely associated with meeting all four targets (all P = 0.01 to P < 0.001).<br />Conclusions: In our US registry of patients with DM, only one in five patients were achieving comprehensive risk factor control. Multifactorial interventions will be necessary to optimize ASCVD risk factor control.<br /> (© 2019 John Wiley & Sons Ltd.)
- Subjects :
- Adult
Aged
Aged, 80 and over
Atherosclerosis blood
Atherosclerosis diagnosis
Atherosclerosis epidemiology
Atherosclerosis prevention & control
Cardiovascular Diseases epidemiology
Diabetes Mellitus blood
Diabetes Mellitus epidemiology
Female
Glycated Hemoglobin analysis
Humans
Male
Middle Aged
Prognosis
Registries
Risk Factors
United States epidemiology
Cardiovascular Diseases diagnosis
Cardiovascular Diseases etiology
Cardiovascular Diseases prevention & control
Diabetes Mellitus diagnosis
Diabetes Mellitus therapy
Patient Care Planning statistics & numerical data
Subjects
Details
- Language :
- English
- ISSN :
- 1463-1326
- Volume :
- 21
- Issue :
- 5
- Database :
- MEDLINE
- Journal :
- Diabetes, obesity & metabolism
- Publication Type :
- Academic Journal
- Accession number :
- 30609214
- Full Text :
- https://doi.org/10.1111/dom.13625