title: Global cardiovascular disease risk assessment in United States adults with diabetes.
abstract: BACKGROUND
  Diabetes mellitus (DM) is often considered a risk equivalent for cardiovascular disease (CVD); however, the variation in CVD risk in adults with DM has not been described.
  
  
  METHODS
  We studied 1114 US adults aged ≥18 years with DM from national survey data and the proportion at low (<10%), intermediate (10-20%) and high (>20%) risk, or with CVD, by age, gender, ethnicity and diabetes type and treatment, and glycaemic and risk factor control by risk group.
  
  
  RESULTS
  Overall, 22.9% were low, 17.5% intermediate, 31.4% high risk and 28.2% had pre-existing CVD (total 59.6% high risk/CVD). More Hispanics (32.4%) and Blacks (30.6%) versus Whites (18.8%) were at lower risk (p<0.0001). Among type 1 versus 2 DM, 35% vs. 65% (p<0.0001) and among insulin users 68.1% were high risk or with CVD. However, among low-intermediate risk, >50% have metabolic syndrome and 7% chronic kidney disease, increasing the high risk/CVD group to 86.8%. Simultaneous achievement of HbA1c, blood pressure and low density lipoprotein-cholesterol goals was low (<15%) regardless of risk group.
  
  
  CONCLUSIONS
  Many DM patients are not at high 10-year CVD risk, but metabolic factors may place them at greater long-term risk. Risk assessment could help target the intensity of treatment.
authors.affiliation: Heart Disease Prevention Program, Division of Cardiology, University of California, 112 Sprague Hall, Irvine, CA 92697, USA. ndwong@uci.edu
authors.forename: Nathan D
authors.initials: ND
authors.lastname: Wong
authors.forename: Diana
authors.initials: D
authors.lastname: Glovaci
authors.forename: Kalina
authors.initials: K
authors.lastname: Wong
authors.forename: Shaista
authors.initials: S
authors.lastname: Malik
authors.forename: Stanley S
authors.initials: SS
authors.lastname: Franklin
authors.forename: Gail
authors.initials: G
authors.lastname: Wygant
authors.forename: Uchenna
authors.initials: U
authors.lastname: Iloeje
mesh_terms: D000293:Adolescent; D000328:Adult; D001741:Black or African American / Q000706:statistics & numerical data; D000368:Aged; D000704:Analysis of Variance; D015415:Biomarkers / Q000097:blood; D002318:Cardiovascular Diseases / Q000097:blood / Q000453:epidemiology* / Q000208:ethnology / Q000503:physiopathology; D015897:Comorbidity; D048909:Diabetes Complications / Q000097:blood / Q000453:epidemiology* / Q000208:ethnology / Q000503:physiopathology; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000453:epidemiology* / Q000208:ethnology / Q000503:physiopathology; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000453:epidemiology* / Q000208:ethnology / Q000503:physiopathology; D005260:Female; D006306:Health Surveys; D006630:Hispanic or Latino / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D018570:Risk Assessment; D012307:Risk Factors; D014481:United States / Q000453:epidemiology; D044465:White People / Q000706:statistics & numerical data; D055815:Young Adult
chemical_list: D015415:Biomarkers