Cardiovascular risk factors and their management in 1282 adult people with type 1 diabetes.
OBJECTIVE
The mortality rate in people with type 1 diabetes (T1D) is over three-times that of their counterparts without diabetes. The underlying reason for this in the developed world is cardiovascular disease (CVD). Strict control of CVD risk factors, for which guidelines now exist, reduces morbidity and mortality. The objective of this study was to determine if these guidelines are being achieved.


METHODS
Data were collected on 1282 adults with T1D from hospitals in the city of Birmingham, UK. Guidelines were those recommended by Joint British Societies: blood pressure (BP) 130/80 mmHg, total cholesterol (TC) 4 mmol/L, non-smoking status, HbA(1c) 6.5% and body mass index (BMI) 25 kg/m(2).


METHODS
The mean age was 46 years and duration of diabetes 21 years. Data on CVD risk factors were poorly documented, with a minimally defined dataset of TC, smoking history and HbA(1c) being completely recorded in only 72% of people. CVD risk factor targets were also poorly achieved with only 0.7% of patients achieving all minimal dataset targets. HbA(1c) and TC targets were those most poorly achieved.


CONCLUSIONS
This is the largest study of CVD risk factors in the UK and the only one to audit the standard of care provided against recent guidelines published by the joint societies. The results show that CVD risk factors are poorly recorded and sub-optimally managed in adults with T1D. Far more aggressive management is essential if mortality rates for T1D in the UK are to be reduced.
Syed
Ateeq
A
University of Birmingham, Edgbaston, Birmingham B15 2TT, UK.
Hussain
Sania
S
Nightingale
Peter
P
De
Parijat
P
Charlton
Mary H
MH
Gangopadhyay
Kalyan
K
Barnett
Anthony H
AH
Narendran
Parth
P
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001794:Blood Pressure; D002318:Cardiovascular Diseases / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology; D003922:Diabetes Mellitus, Type 1 / Q000150:complications*; D005260:Female; D006801:Humans; D006943:Hyperglycemia / Q000188:drug therapy; D008055:Lipids / Q000097:blood; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D012737:Sex Factors; D012907:Smoking
D008055:Lipids