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Composite cardiovascular risk factor target achievement and its predictors in US adults with diabetes: The Diabetes Collaborative Registry.

Authors :
Fan, Wenjun
Fan, Wenjun
Song, Yang
Inzucchi, Silvio E
Sperling, Laurence
Cannon, Christopher P
Arnold, Suzanne V
Kosiborod, Mikhail
Wong, Nathan D
Fan, Wenjun
Fan, Wenjun
Song, Yang
Inzucchi, Silvio E
Sperling, Laurence
Cannon, Christopher P
Arnold, Suzanne V
Kosiborod, Mikhail
Wong, Nathan D
Source :
Diabetes, obesity & metabolism; vol 21, iss 5, 1121-1127; 1462-8902
Publication Year :
2019

Abstract

AimTo 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.MethodsIn 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.ResultsIn 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).ConclusionsIn 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.

Details

Database :
OAIster
Journal :
Diabetes, obesity & metabolism; vol 21, iss 5, 1121-1127; 1462-8902
Notes :
application/pdf, Diabetes, obesity & metabolism vol 21, iss 5, 1121-1127 1462-8902
Publication Type :
Electronic Resource
Accession number :
edsoai.on1367411788
Document Type :
Electronic Resource