title: Achievement of treatment goals for secondary prevention of myocardial infarction or stroke in 29,325 patients with type 2 diabetes: a German/Austrian DPV-multicenter analysis.
abstract: BACKGROUND
  To analyze whether medical care is in accordance with guidelines for secondary prevention of myocardial infarction (MI), or stroke in patients with type 2 diabetes from Germany and Austria.
  
  
  METHODS
  29,325 patients (≥ 20 years of age) with type 2 diabetes and MI, or stroke, documented between 2006 and 2015 were selected from the Diabetes-Patienten-Verlaufsdokumentation database. We analyzed medication, clinical characteristics, and lifestyle factors according to national secondary prevention guidelines in patients with MI, or stroke, separately.
  
  
  RESULTS
  HbA1C <7.5 % was achieved in 64.9 % (MI), and in 61.1 % (stroke) of patients. LDL <100 mg/dl was documented in 56.2 % (MI), and in 42.2 % (stroke). Non-smoking was reported in 92.0 % (MI), and in 93.1 % (stroke), physical activity in 9.6 % (MI), and 5.5 % (stroke). Target values of blood pressure (<130/80 mmHg in MI, 120/70-140/90 in stroke) were reached in 67.0 % (MI), and in 89.9 % (stroke). Prescription prevalence of inhibitors of platelet aggregation (IPA) was 50.7 % (MI), and 31.7 % (stroke). 57.0 % (MI), and 40.1 % (stroke) used statins, 65.1 % (MI), and 65.8 % (stroke) used any type of antihypertensives, and ACE inhibitors were prescribed in 49.7 % (MI), and 41.3 % (stroke). A body mass index (BMI) <27 kg/m(2) and the use of beta blockers were only recommended in subjects with MI. Of the patients with MI, 32.0 % had a BMI <27 kg/m(2), and 59.5 % used beta blockers.
  
  
  CONCLUSIONS
  Achievement of treatment goals in secondary prevention of MI, or stroke in subjects with type 2 diabetes needs improvement. Target goals were met more frequently in patients with MI compared to subjects with stroke. Especially the use of IPA was very low in patients with stroke. There remains great potential to reduce the risk of repeated macrovascular events and premature death, as well as to increase patients' quality of life.
authors.affiliation: Institute of Epidemiology and Medical Biometry, ZIBMT, University of Ulm, Albert-Einstein-Allee 41, 89081, Ulm, Germany. barbara.bohn@uni-ulm.de.|German Center for Diabetes Research (DZD), Munich-Neuherberg, Germany. barbara.bohn@uni-ulm.de.
authors.forename: Barbara
authors.initials: B
authors.lastname: Bohn
authors.affiliation: Division of Endocrinology and Diabetes, Department of Medicine I, University Hospital Erlangen, Friedrich-Alexander-University, Erlangen-Nuremberg, Germany.
authors.forename: Christof
authors.initials: C
authors.lastname: Schöfl
authors.affiliation: Department for Internal Medicine, Protestant Hospital Zweibrücken, Zweibrücken, Germany.|Department of Medicine II, Saarland University Medical Center, Homburg, Germany.
authors.forename: Vincent
authors.initials: V
authors.lastname: Zimmer
authors.affiliation: Specialized Diabetes Practice Rosenheim & Institute of Diabetes Research, Helmholtz Center Munich, Munich, Germany.
authors.forename: Michael
authors.initials: M
authors.lastname: Hummel
authors.affiliation: Alb Fils Kliniken, Helfenstein Clinic, Geislingen, Germany.
authors.forename: Nikolai
authors.initials: N
authors.lastname: Heise
authors.affiliation: Department of Internal Medicine, St. Josefs Hospital, Heidelberg, Germany.
authors.forename: Erhard
authors.initials: E
authors.lastname: Siegel
authors.affiliation: Division of Endocrinology and Diabetes, RWTH Aachen University, Aachen, Germany.
authors.forename: Wolfram
authors.initials: W
authors.lastname: Karges
authors.affiliation: Division of Endocrinology and Metabolism, Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria.
authors.forename: Michaela
authors.initials: M
authors.lastname: Riedl
authors.affiliation: Institute of Epidemiology and Medical Biometry, ZIBMT, University of Ulm, Albert-Einstein-Allee 41, 89081, Ulm, Germany.|German Center for Diabetes Research (DZD), Munich-Neuherberg, Germany.
authors.forename: Reinhard W
authors.initials: RW
authors.lastname: Holl
mesh_terms: D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001317:Austria; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000188:drug therapy*; D005260:Female; D005858:Germany; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control*; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use*; D011788:Quality of Life; D012307:Risk Factors; D055502:Secondary Prevention / Q000706:statistics & numerical data*; D020521:Stroke / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control*; D055815:Young Adult
chemical_list: D000319:Adrenergic beta-Antagonists; D010975:Platelet Aggregation Inhibitors
keywords: Guideline adherence; Myocardial infarction; Secondary prevention; Stroke; Type 2 diabetes