Optimizing diabetes care regarding cardiovascular targets at general practice level: Direct@GP.

Abstract

The objective of this study was to assess the adherence to national guidelines on cardiovascular (CV) prevention and target attainment for patients with type 2 diabetes mellitus followed-up in general practice. Non-interventional, cross-sectional survey. Type 2 diabetes patients remain undertreated with statins (63% treated), even so those with a cardiovascular history (80% treated). Although more patients received antihypertensive treatment (82%) compared to hypolipidemic medication (69%), the proportion of patients attaining targets for total cholesterol (TC) (35%), HDL-cholesterol (HDL-C) (65%), and LDL-cholesterol (LDL-C) (42%) exceeded far those attaining blood pressure control (13%). The primary endpoint of reaching the goal for LDL-cholesterol (<100mg/dL; 2.59 mmol/L) was attained by 42% of patients, of which only 13% reached the more stringent target of LDL-C<70 mg/dL (1.81 mmol/L). About half of the patients (49%) attained glycemic control (HbA1c<7%) and 55% had triglycerides<150 mg/dL (1.69 mmol/L). The majority of type 2 diabetes patients are treated for hypercholesterolemia and hypertension, although, there is still under treatment, especially in patients with CV disease. Only 42% of patients were on target for LDL-cholesterol and 13% for blood pressure. Therefore, wider implementation of process and outcome indicators, which proved to be related, and continuous evaluation of their result, is needed.