[Effectiveness of cardiometabolic risk reduction in patients with type 1 diabetes mellitus].
The attainment and maintenance of therapeutic goal of cardiovascular risk factors are of great clinical importance. The effectiveness of cardiovascular risk management is not well characterized during regular care of patients with type 1 diabetes mellitus.


OBJECTIVE
The aim of the study was to estimate the effectiveness of cardiovascular risk management in type 1 diabetic patients.


METHODS
Adult patients with type 1 diabetes mellitus (n = 533; 256 men, 277 women; age: 35.6 +/- 11.6 years; duration of diabetes: 18.0 +/- 11.1 years; x +/- SD) were consecutively enrolled from 11 diabetes outpatient departments. Data on medical history, actual treatment, anthropometric and laboratory parameters as well as actual blood pressure were registered, while eating and smoking habits, education level and physical activity were evaluated by standardized questionnaires. The treating goal was set according to the national guideline which corresponds to the current international task force.


RESULTS
Of 533 patients, the body mass index target level (< 25 kg/m 2 ) was achieved by 295 (55.5%) patients. Ideal waist circumference (< 80 cm for women and < 94 cm for men) was measured in 140 (50.5%) and in 165 (63.7%) patients, respectively. Optimal glycaemic control (HbA 1c level < 6.5%) was documented in 45 (8.4%) patients. Lipid lowering drugs (statins, fibrates or ezetimibe) were used by 130 patients, among which 53.1% reached the target triglyceride level, 71.5% the target HDL-cholesterol and 27.8% the target LDL-cholesterol levels. Taking the lipid target values together, only 23 (17.7%) patients were at goal. Antihypertensive drugs were used by 173 patients among which 29.5% reached the systolic and 34.8% the diastolic target values (< 130/80 mmHg). Regarding smoking habits, 94 (17.7%) patients were current smokers and 102 (19.2%) ex-smokers.


CONCLUSIONS
The attainment of therapeutic goal of cardiovascular risk factors proved to be difficult in a substantial part of patients. Further efforts are needed for attaining and maintaining the established goal of cardiovascular risk management during regular care of adult patients with type 1 diabetes mellitus.
Nádas
Judit
J
Bajcsy-Zsilinszky Kórház Budapest.
Putz
Zsuzsanna
Z
Fövényi
József
J
Gaál
Zsolt
Z
Gyimesi
András
A
Hídvégi
Tibor
T
Hosszúfalusi
Nóra
N
Neuwirth
Gyula
G
Oroszlán
Tamás
T
Pánczél
Pál
P
Vándorfi
Gyozo
G
Winkler
Gábor
G
Wittmann
István
I
Jermendy
György
G
D000328:Adult; D000924:Anticholesteremic Agents / Q000008:administration & dosage*; D000959:Antihypertensive Agents / Q000008:administration & dosage*; D001384:Azetidines / Q000008:administration & dosage; D001794:Blood Pressure; D015992:Body Mass Index; D008076:Cholesterol, HDL / Q000097:blood; D008078:Cholesterol, LDL / Q000097:blood; D002995:Clofibric Acid / Q000008:administration & dosage; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000150:complications* / Q000378:metabolism* / Q000503:physiopathology; D000069438:Ezetimibe; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D006814:Hungary; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000008:administration & dosage; D007004:Hypoglycemic Agents / Q000008:administration & dosage*; D008297:Male; D024821:Metabolic Syndrome / Q000097:blood / Q000209:etiology / Q000378:metabolism* / Q000503:physiopathology / Q000517:prevention & control*; D008875:Middle Aged; D017410:Practice Guidelines as Topic; D018570:Risk Assessment; D012307:Risk Factors; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D014280:Triglycerides / Q000097:blood
D000924:Anticholesteremic Agents; D000959:Antihypertensive Agents; D001384:Azetidines; D008076:Cholesterol, HDL; D008078:Cholesterol, LDL; D002995:Clofibric Acid; D000069438:Ezetimibe; D006442:Glycated Hemoglobin; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D007004:Hypoglycemic Agents; D014280:Triglycerides; C517652:hemoglobin A1c protein, human