Contrasting cardiovascular risk profiles and prescribed cardio-protective therapies in newly-diagnosed type 2 diabetes identified through screening and standard practice

Abstract Aims Screening for Type 2 diabetes mellitus (T2DM) may improve long-term outcomes by managing cardiovascular risk at an earlier stage of the disease. The cardiovascular risk profile of screen-detected (SD) T2DM is ill defined and has not been compared to conventional newly diagnosed (CD) ca...

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Bibliographic Details
Published in:Diabetes research and clinical practice 2011-03, Vol.91 (3), p.280-285
Main Authors: Webb, D.R, Gray, L.J, Khunti, K, Campbell, S, Dallosso, H, Davies, M.J
Format: Article
Language:English
Subjects:
Adult
Aged
Antihypertensive Agents - therapeutic use
Cardiotonic Agents - therapeutic use
Cardiovascular disease
Cardiovascular Diseases
Diabetes Mellitus, Type 2 - complications
Diabetes Mellitus, Type 2 - drug therapy
Diagnosis
Dyslipidemias - complications
Endocrinology & Metabolism
Humans
Hyperglycemia - complications
Hypertension - complications
Hypolipidemic Agents - therapeutic use
Mass Screening
Middle Aged
Risk Factors
Screening
Type 2 Diabetes
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Summary:Abstract Aims Screening for Type 2 diabetes mellitus (T2DM) may improve long-term outcomes by managing cardiovascular risk at an earlier stage of the disease. The cardiovascular risk profile of screen-detected (SD) T2DM is ill defined and has not been compared to conventional newly diagnosed (CD) cases. Methods Baseline data from SD ( n = 337) and CD ( n = 824) cohorts were compared. SD adopted mixed approaches to screening, population based ( n = 214) and cardiovascular-risk factor targeted ( n = 123). CD reflected UK primary care practice with cases referred within four weeks of diagnosis. Results People with SD T2DM were leaner, had a lower HbA1c(%) and lower triglyceride but were more hypertensive compared to people with CD T2DM. Fewer SD were on blood pressure lowering (46% vs. 60%, p < 0.0001), statin (30% vs. 41%, p < 0.0001) or anti-platelet (15% vs. 27%, p < 0.0001) therapies. Modelled 10 year cardiovascular disease (CVD) risk was actually greater in the SD group compared to CD (CVD: 20.8 vs. 17.2, p = 0.0001). Conclusion Individuals with SD T2DM are at high risk of CVD as a result of untreated hyperglycaemia, hypertension and dyslipidaemia. Those prescribed antihypertensive or lipid-lowering therapies frequently still had inadequate control. Identifying vascular risk by screening for latent glucose disease provides therapeutic opportunities for earlier intervention.
ISSN:0168-8227
1872-8227
DOI:10.1016/j.diabres.2010.11.021