title: Impact of carotid atherosclerosis detection on physician and patient behavior in the management of type 2 diabetes mellitus: a prospective, observational, multicenter study.
abstract: This study compared carotid ultrasound (CUS) and traditional risk calculations in determining cardiovascular disease (CVD) risk in patients with type 2 diabetes mellitus (DM) and investigated whether awareness of CVD affects patient and/or physician behavior.
  
  
  
  In this prospective, observational, multicenter study, 797 participants with type 2 diabetes were assessed using CUS, the United Kingdom Prospective Diabetes Study Risk Engine (UKPDSRE) calculator, and the Framingham Risk Score (FRS) algorithm. Health-related behaviors and physician treatments were compared at baseline and at 6 months after assessment.
  
  
  
  According to CUS, 43.5 % of the participants were at high risk (compared to 10.6 % and 4.3 % using the UKPDSRE and FRS approaches, respectively). Interestingly, 31.5 % of the patients with low risk scores according to the UKPDSRE calculator and 35.8 % of the patients with low risk scores according to the FRS algorithm were found to be at high risk according to CUS. The proportion of patients who achieved target LDL-C levels significantly increased after CUS. Moreover, increased awareness of atherosclerosis through CUS findings significantly altered physician treatment patterns and patient health-related behaviors.
  
  
  
  Carotid atherosclerosis was detected in more than 30 % of all participants with low or intermediate risk stratification scores. Improved awareness of atherosclerosis through CUS findings had a positive impact on both patient and physician behavior, resulting in improved CV risk management.
authors.affiliation: Department of Endocrinology and Metabolism, Kyung Hee University School of Medicine, Kyung Hee University Hospital at Gangdong, Seoul, South Korea.
authors.forename: In-Kyung
authors.initials: IK
authors.lastname: Jeong
authors.affiliation: Korea University Anam Hospital, Seoul, South Korea.
authors.forename: Sin-Gon
authors.initials: SG
authors.lastname: Kim
authors.affiliation: Chonnam National University Hospital, Gwangju, South Korea.
authors.forename: Dong Hyeok
authors.initials: DH
authors.lastname: Cho
authors.affiliation: Sejong General Hospital, Gyeonggi-do, South Korea.
authors.forename: Chong Hwa
authors.initials: CH
authors.lastname: Kim
authors.affiliation: Hallym University Sacred Heart Hospital, Gyeonggi-do, South Korea.
authors.forename: Chul Sik
authors.initials: CS
authors.lastname: Kim
authors.affiliation: Kangbuk Samsung Hospital, Seoul, South Korea.
authors.forename: Won-Young
authors.initials: WY
authors.lastname: Lee
authors.affiliation: Yeungnam University Medical Center, Daegu, South Korea.
authors.forename: Kyu-Chang
authors.initials: KC
authors.lastname: Won
authors.affiliation: Department of Internal Medicine, Kangdong Sacred Heart Hospital, Hallym University Medical Center, Gil-Dong, Gangdong-Gu, Seoul, South Korea. dm@hallym.or.kr.
authors.forename: Doo-Man
authors.initials: DM
authors.lastname: Kim
mesh_terms: D000328:Adult; D050197:Atherosclerosis / Q000175:diagnosis* / Q000453:epidemiology / Q000209:etiology; D001519:Behavior; D002339:Carotid Arteries / Q000000981:diagnostic imaging* / Q000503:physiopathology; D002340:Carotid Artery Diseases / Q000175:diagnosis* / Q000453:epidemiology / Q000209:etiology; D059168:Carotid Intima-Media Thickness; D003924:Diabetes Mellitus, Type 2 / Q000150:complications* / Q000175:diagnosis; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010361:Patients / Q000523:psychology*; D010820:Physicians / Q000523:psychology*; D011446:Prospective Studies; D018570:Risk Assessment / Q000379:methods; D012307:Risk Factors; D013997:Time Factors; D006113:United Kingdom / Q000453:epidemiology
keywords: Behavior; Cardiovascular disease; Carotid atherosclerosis; Diabetes mellitus; Type 2