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Vol 3, No 6 (2014)
Original articles (submitted)
Published online: 2015-01-20
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Metabolic control of type 2 diabetes in cardiac patients — with respect to the changing Diabetes Poland guidelines

Agnieszka Kapłon-Cieślicka, Marek Postuła, Marek Rosiak, Agnieszka Serafin, Agnieszka Kondracka, Ewa Trzepla, Grzegorz Opolski, Krzysztof J. Filipiak
Diabetologia Kliniczna 2014;3(6):227-237.

open access

Vol 3, No 6 (2014)
Original articles (submitted)
Published online: 2015-01-20

Abstract

Introduction. Diabetes mellitus significantly increases the risk of cardiovascular events. The aim of the study was to assess diabetes control in type 2 diabetic patients with coexisting cardiovascular disease.

 

Material and methods. A total of 293 type 2 diabetic patients with coexisting additional cardiovascular risk factors, recruited from the prospective AVOCADO study (2008–2011), were included in the analysis. Evaluation of diabetes control was conducted in accordance with the 2008, 2011 and 2014 Diabetes Poland guidelines.

Results. Mean patient age was 67.4 years, and median duration of diabetes was 8 years. Two-thirds of patients were treated solely with oral antidiabetic drugs, 13.7% of patients were on insulin monotherapy and 19.8% of patients received a combination of oral antidiabetic drugs and insulin. Hypertension was present in 91.5%, coronary artery disease in 54.6%, previous myocardial infarction in 30.7% and previous stroke or transient ischemic attack in 9.9% of patients. Median glycated hemoglobin (HbA1c) was 6.6%. A proportion of HbA1c of ≤ 7% was achieved in 74.4% of patients. Glycemic compensation according to 2008 Polish Diabetes guidelines was achieved in 46.1% of patients, and according to 2011 and 2014 guidelines — in 57.3% of patients. Therapeutic goals in terms of total cholesterol concentration were achieved in 62.1%, LDL cholesterol concentration in 43.4%, HDL cholesterol concentration in 53.9%, triglyceride concentration in 67.9% of patients. Therapeutic goals in terms of blood pressure values were achieved in 13.7%, 39.6% and 34.5% of patients according to Polish Diabetes 2008, 2011 and 2014 guidelines, respectively. Only 2.1%, 6.5% and 4.8% of patients fulfilled all the compensation criteria according to Polish Diabetes 2008, 2011 and 2014 guidelines, respectively. Only 10.3% of patients had a normal body mass index.

Conclusions. In comparison to other polish studies and registries, the study group of type 2 diabetic patients with coexisting cardiovascular diseases was characterized by a relatively good diabetes control. Out of all the metabolic therapeutic goals, reduction in LDL cholesterol concentration was the most difficult to achieve. Only a small proportion of patients fulfilled all the compensation criteria, irrespective of the guidelines used for diabetes control assessment.

Abstract

Introduction. Diabetes mellitus significantly increases the risk of cardiovascular events. The aim of the study was to assess diabetes control in type 2 diabetic patients with coexisting cardiovascular disease.

 

Material and methods. A total of 293 type 2 diabetic patients with coexisting additional cardiovascular risk factors, recruited from the prospective AVOCADO study (2008–2011), were included in the analysis. Evaluation of diabetes control was conducted in accordance with the 2008, 2011 and 2014 Diabetes Poland guidelines.

Results. Mean patient age was 67.4 years, and median duration of diabetes was 8 years. Two-thirds of patients were treated solely with oral antidiabetic drugs, 13.7% of patients were on insulin monotherapy and 19.8% of patients received a combination of oral antidiabetic drugs and insulin. Hypertension was present in 91.5%, coronary artery disease in 54.6%, previous myocardial infarction in 30.7% and previous stroke or transient ischemic attack in 9.9% of patients. Median glycated hemoglobin (HbA1c) was 6.6%. A proportion of HbA1c of ≤ 7% was achieved in 74.4% of patients. Glycemic compensation according to 2008 Polish Diabetes guidelines was achieved in 46.1% of patients, and according to 2011 and 2014 guidelines — in 57.3% of patients. Therapeutic goals in terms of total cholesterol concentration were achieved in 62.1%, LDL cholesterol concentration in 43.4%, HDL cholesterol concentration in 53.9%, triglyceride concentration in 67.9% of patients. Therapeutic goals in terms of blood pressure values were achieved in 13.7%, 39.6% and 34.5% of patients according to Polish Diabetes 2008, 2011 and 2014 guidelines, respectively. Only 2.1%, 6.5% and 4.8% of patients fulfilled all the compensation criteria according to Polish Diabetes 2008, 2011 and 2014 guidelines, respectively. Only 10.3% of patients had a normal body mass index.

Conclusions. In comparison to other polish studies and registries, the study group of type 2 diabetic patients with coexisting cardiovascular diseases was characterized by a relatively good diabetes control. Out of all the metabolic therapeutic goals, reduction in LDL cholesterol concentration was the most difficult to achieve. Only a small proportion of patients fulfilled all the compensation criteria, irrespective of the guidelines used for diabetes control assessment.

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Keywords

type 2 diabetes mellitus, glycated hemoglobin, cholesterol, triglycerides, cardiovascular diseases

About this article
Title

Metabolic control of type 2 diabetes in cardiac patients — with respect to the changing Diabetes Poland guidelines

Journal

Clinical Diabetology

Issue

Vol 3, No 6 (2014)

Pages

227-237

Published online

2015-01-20

Bibliographic record

Diabetologia Kliniczna 2014;3(6):227-237.

Keywords

type 2 diabetes mellitus
glycated hemoglobin
cholesterol
triglycerides
cardiovascular diseases

Authors

Agnieszka Kapłon-Cieślicka
Marek Postuła
Marek Rosiak
Agnieszka Serafin
Agnieszka Kondracka
Ewa Trzepla
Grzegorz Opolski
Krzysztof J. Filipiak

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