Time trends in absolute and modifiable CHD risk in type 2 diabetes patients in the Swedish national diabetes register (NDR) 2003–2008
2012 (English)In: Diabetic Medicine, ISSN 0742-3071, E-ISSN 1464-5491, Vol. 29, no 2, 198-206 p.Article in journal (Other academic) Published
Aims: The aim was to evaluate treatment goal achievements early in the course of Type 2 diabetes, and their effect on 10-year risk of coronary heart disease in patients receiving usual care.
Methods: Assessment of risk factor control 3 years after diagnosis in patients with Type 2 diabetes with no previous coronary heart disease included from the Swedish National Diabetes Register; a total of 19 382 patients (mean age 58 years) in cross-sectional surveys from 2003 to 2008, and a subgroup of 4293 patients followed individually from year of diagnosis to follow-up after a mean 2.6 years. Estimation of absolute 10-year risk of coronary heart disease using the UK Prospective Diabetes Study risk engine, and modifiable 10-year risk defined as percentage excess risk above patients with normal risk factor values.
Results: Treatment goals for HbA1c, blood pressure, total and LDL cholesterol were achieved in 78.4, 65.5, 55.6% and 61.0%, respectively, in the cross-sectional survey in 2008, following a trend of generally improved control. In the individually followed patients in the subgroup, mean absolute 10-year coronary heart disease risk increased from 13.7% (men/women 16.9/9.5%) to 14.2 (men/women 17.6/9.6%) (P < 0.001) from year of diagnosis to follow-up after 2.6 years, while mean modifiable risk decreased from 37.7% (men/women 28.6/49.9%) to 19.1% (13.2/26.9%) (P < 0.001 in all).
Conclusions: A high achievement of treatment goals and a low mean modifiable 10-year coronary heart disease risk was found at the 3-year follow-up, both in the cross-sectional survey in 2008 and in patients individually followed since diagnosis. This indicates the feasibility and significance of early multifactorial risk factor treatment.
Place, publisher, year, edition, pages
Malde, USA: Wiley-Blackwell, 2012. Vol. 29, no 2, 198-206 p.
blood pressure, diabetes mellitus, dyslipidaemia, HbA1c, myocardial infarction
Endocrinology and Diabetes
IdentifiersURN: urn:nbn:se:umu:diva-30685DOI: 10.1111/j.1464-5491.2011.03425.xOAI: oai:DiVA.org:umu-30685DiVA: diva2:285726