title: Blood pressure and lipid management fall far short in persons with type 2 diabetes: results from the DIAB-CORE Consortium including six German population-based studies.
abstract: BACKGROUND
  Although most deaths among patients with type 2 diabetes (T2D) are attributable to cardiovascular disease, modifiable cardiovascular risk factors appear to be inadequately treated in medical practice. The aim of this study was to describe hypertension, dyslipidemia and medical treatment of these conditions in a large population-based sample.
  
  
  METHODS
  The present analysis was based on the DIAB-CORE project, in which data from five regional population-based studies and one nationwide German study were pooled. All studies were conducted between 1997 and 2006. We assessed the frequencies of risk factors and co-morbidities, especially hypertension and dyslipidemia, in participants with and without T2D. The odds of no or insufficient treatment and the odds of pharmacotherapy were computed using multivariable logistic regression models. Types of medication regimens were described.
  
  
  RESULTS
  The pooled data set comprised individual data of 15, 071 participants aged 45-74 years, including 1287 (8.5%) participants with T2D. Subjects with T2D were significantly more likely to have untreated or insufficiently treated hypertension, i.e. blood pressure of > = 140/90 mmHg (OR = 1.43, 95% CI 1.26-1.61) and dyslipidemia i.e. a total cholesterol/HDL-cholesterol ratio > = 5 (OR = 1.80, 95% CI 1.59-2.04) than participants without T2D. Untreated or insufficiently treated blood pressure was observed in 48.9% of participants without T2D and in 63.6% of participants with T2D. In this latter group, 28.0% did not receive anti-hypertensive medication and 72.0% were insufficiently treated. In non-T2D participants, 28.8% had untreated or insufficiently treated dyslipidemia. Of all participants with T2D 42.5% had currently elevated lipids, 80.3% of these were untreated and 19.7% were insufficiently treated.
  
  
  CONCLUSIONS
  Blood pressure and lipid management fall short especially in persons with T2D across Germany. The importance of sufficient risk factor control besides blood glucose monitoring in diabetes care needs to be emphasized in order to prevent cardiovascular sequelae and premature death.
authors.affiliation: Institute of Epidemiology II, Helmholtz Zentrum München, German Research Center for Environmental Health, Ingolstädter Landstrasse 1, D-85764, München/Neuherberg, Germany. ina-maria.rueckert@helmholtz-muenchen.de
authors.forename: Ina-Maria
authors.initials: IM
authors.lastname: Rückert
authors.forename: Michaela
authors.initials: M
authors.lastname: Schunk
authors.forename: Rolf
authors.initials: R
authors.lastname: Holle
authors.forename: Sabine
authors.initials: S
authors.lastname: Schipf
authors.forename: Henry
authors.initials: H
authors.lastname: Völzke
authors.forename: Alexander
authors.initials: A
authors.lastname: Kluttig
authors.forename: Karin-Halina
authors.initials: KH
authors.lastname: Greiser
authors.forename: Klaus
authors.initials: K
authors.lastname: Berger
authors.forename: Grit
authors.initials: G
authors.lastname: Müller
authors.forename: Ute
authors.initials: U
authors.lastname: Ellert
authors.forename: Hannelore
authors.initials: H
authors.lastname: Neuhauser
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Rathmann
authors.forename: Teresa
authors.initials: T
authors.lastname: Tamayo
authors.forename: Susanne
authors.initials: S
authors.lastname: Moebus
authors.forename: Silke
authors.initials: S
authors.lastname: Andrich
authors.forename: Christa
authors.initials: C
authors.lastname: Meisinger
mesh_terms: D000368:Aged; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D015415:Biomarkers / Q000097:blood; D001794:Blood Pressure / Q000187:drug effects*; D016009:Chi-Square Distribution; D015897:Comorbidity; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000188:drug therapy* / Q000453:epidemiology / Q000503:physiopathology; D050171:Dyslipidemias / Q000097:blood / Q000188:drug therapy* / Q000453:epidemiology; D005260:Female; D005858:Germany / Q000453:epidemiology; D019983:Guideline Adherence / Q000706:statistics & numerical data; D006801:Humans; D006973:Hypertension / Q000188:drug therapy* / Q000453:epidemiology / Q000503:physiopathology; D000960:Hypolipidemic Agents / Q000627:therapeutic use*; D008055:Lipids / Q000097:blood*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data; D018570:Risk Assessment; D012307:Risk Factors; D016896:Treatment Outcome
chemical_list: D000959:Antihypertensive Agents; D015415:Biomarkers; D000960:Hypolipidemic Agents; D008055:Lipids