Prevalence of cardiovascular disease and evaluation of standard of care in type 2 diabetes: a nationwide study in primary care

TY - JOUR

T1 - Prevalence of cardiovascular disease and evaluation of standard of care in type 2 diabetes

T2 - a nationwide study in primary care

AU - Rungby, Jorgen

AU - Schou, Morten

AU - Warrer, Per

AU - Ytte, Lars

AU - Andersen, Gert S

PY - 2017/12

Y1 - 2017/12

N2 - Objective: Cardiovascular disease (CVD) complicates type 2 diabetes. Empagliflozin and liraglutide have demonstrated improved survival in patients with type 2 diabetes and established CVD. We assessed prevalence and standard of care of patients with type 2 diabetes and established CVD managed in primary care.Patients and methods: A total of 129 general practitioners in both rural and urban areas, responsible for 348 373 patients, identified their patients with type 2 diabetes. The identification was based on a search for International Classification of Primary Health Care 2 codes in the general practitioners' electronic patient record systems. Patients with concomitant CVD were identified and characterized.Results: A total of 17 113 (4.9%) patients were diagnosed with type 2 diabetes. Type 2 diabetes with concomitant CVD was found in 3665 (21.4%) patients, with their mean age being 72 years, and 34.6% were women. Mean estimated glomerular filtration rate was 68.2 ml/min, and 22.2% had microalbuminuria or macroalbuminuria. Standard of care was fair: mean glycated hemoglobin was 52.3 mmol/mol (Diabetes Control and Complications Trial=6.9%), mean blood pressure was 131.4/75.7 mmHg, and mean low-density lipoprotein cholesterol was 2.0 mmol/l.Conclusion: In a nationwide database survey in primary care, the prevalence of CVD in patients with type 2 diabetes was high (21.4%). Standard of care was largely in accordance with national guidelines. Identification of eligible patients is possible with existing electronic patient record systems. Identifying this high-risk subgroup of patients with type 2 diabetes and optimizing their treatment might add further cardiovascular benefits as suggested by recent cardiovascular outcome trials.

AB - Objective: Cardiovascular disease (CVD) complicates type 2 diabetes. Empagliflozin and liraglutide have demonstrated improved survival in patients with type 2 diabetes and established CVD. We assessed prevalence and standard of care of patients with type 2 diabetes and established CVD managed in primary care.Patients and methods: A total of 129 general practitioners in both rural and urban areas, responsible for 348 373 patients, identified their patients with type 2 diabetes. The identification was based on a search for International Classification of Primary Health Care 2 codes in the general practitioners' electronic patient record systems. Patients with concomitant CVD were identified and characterized.Results: A total of 17 113 (4.9%) patients were diagnosed with type 2 diabetes. Type 2 diabetes with concomitant CVD was found in 3665 (21.4%) patients, with their mean age being 72 years, and 34.6% were women. Mean estimated glomerular filtration rate was 68.2 ml/min, and 22.2% had microalbuminuria or macroalbuminuria. Standard of care was fair: mean glycated hemoglobin was 52.3 mmol/mol (Diabetes Control and Complications Trial=6.9%), mean blood pressure was 131.4/75.7 mmHg, and mean low-density lipoprotein cholesterol was 2.0 mmol/l.Conclusion: In a nationwide database survey in primary care, the prevalence of CVD in patients with type 2 diabetes was high (21.4%). Standard of care was largely in accordance with national guidelines. Identification of eligible patients is possible with existing electronic patient record systems. Identifying this high-risk subgroup of patients with type 2 diabetes and optimizing their treatment might add further cardiovascular benefits as suggested by recent cardiovascular outcome trials.

U2 - 10.1097/XCE.0000000000000135

DO - 10.1097/XCE.0000000000000135

M3 - Journal article

C2 - 29276653

SN - 2162-688X

VL - 6

SP - 145

EP - 151

JO - Cardiovascular Endocrinology

JF - Cardiovascular Endocrinology

IS - 4

ER -