title: Contrasting cardiovascular risk profiles and prescribed cardio-protective therapies in newly-diagnosed type 2 diabetes identified through screening and standard practice.
abstract: OBJECTIVE
  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).
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Cardiovascular Sciences, University of Leicester, UK. drw17@le.ac.u
authors.forename: D R
authors.initials: DR
authors.lastname: Webb
authors.forename: L J
authors.initials: LJ
authors.lastname: Gray
authors.forename: K
authors.initials: K
authors.lastname: Khunti
authors.forename: S
authors.initials: S
authors.lastname: Campbell
authors.forename: H
authors.initials: H
authors.lastname: Dallosso
authors.forename: M J
authors.initials: MJ
authors.lastname: Davies
mesh_terms: D000328:Adult; D000368:Aged; D000959:Antihypertensive Agents / Q000627:therapeutic use; D002316:Cardiotonic Agents / Q000627:therapeutic use; D002318:Cardiovascular Diseases; D003924:Diabetes Mellitus, Type 2 / Q000150:complications* / Q000188:drug therapy*; D050171:Dyslipidemias / Q000150:complications; D006801:Humans; D006943:Hyperglycemia / Q000150:complications; D006973:Hypertension / Q000150:complications; D000960:Hypolipidemic Agents / Q000627:therapeutic use; D008403:Mass Screening; D008875:Middle Aged; D012307:Risk Factors
chemical_list: D000959:Antihypertensive Agents; D002316:Cardiotonic Agents; D000960:Hypolipidemic Agents