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Recognition and management of cardiovascular risk factors in type 2 diabetes

Hospital, Lyndhurst Road, Worthing, BN11 2DH, West Sussex, UK, sara.da-costa{at}wash.nhs.uk

Patients with type 2 diabetes face an increased risk of cardiovascular disease compared with the general population. The UKPDS identified a number of potentially modifiable risk factors including hypertension, increased low-density lipoprotein cholesterol, decreased high-density lipoprotein cholesterol, hyperglycaemia and smoking. Recognising and managing these risk factors presents a challenge for clinical practice, particularly if we aim to also identify at-risk individuals. The prevalence of type 2 diabetes is escalating, largely due to an ageing population and the rapidly increasing incidence of obesity, which in itself has become a recognised risk factor for type 2 diabetes. The challenge for healthcare professionals in the management of type 2 diabetes is a complex one, at the heart of which is the need for patient education and support to promote sustainable lifestyle changes. In addition to recognising classical risk factors, evidence from clinical practice highlights the impact of non-classical risk factors (such as non-compliance to medication) and the subsequent consequences they have on resource and patient outcomes, thereby reinforcing the necessity for an integrated approach to the management of type 2

Key Words: type 2 diabetes • cardiovascular disease • modifiable risk factors • integrated management.

References

• Almdal T., Scharling H., Jensen JS et al. The independent effect of type 2 diabetes mellitus on ischemic heart disease, stroke, and death: a population-based study of 13,000 men and women with 20 years of follow-up. Arch Intern Med 2004;164:1422-6.[Abstract/Free Full Text]
• Turner RC, Millns H., Neil HA et al. Risk factors for coronary artery disease in non-insulin dependent diabetes mellitus: United Kingdom Prospective Diabetes Study (UKPDS: 23). BMJ 1998;316:823-8.[Abstract/Free Full Text]
• Krentz AJ, Bailey CJ Type 2 Diabetes in Practice. Royal Society of Medicine Press, 2001.
• Castelli WP Cholesterol and lipids in the risk of coronary artery disease - The Framingham Heart Study. Can J Cardiol 1988;4(suppl A):5A-10A.[Medline] [Order article via Infotrieve]
• Betteridge DJ Diabetic dyslipidaemia: past, present and future. Pract Diab Int 2004;21:78-85.[CrossRef]
• Heart Protection Study Collaborative Group. MRC/BHF Heart protection Study of cholesterol-lowering with simvastatin in 5963 people with diabetes: a randomised placebo-controlled trial. Lancet 2003;361:2005-16.[CrossRef][Web of Science][Medline] [Order article via Infotrieve]
• Nice. Management of type 2 diabetes. Endocrine 2005;26:239-68.
• British Cardiac Society, British Hypertension Society, Diabetes UK et al. JBS 2: Joint British Societies' guidelines on prevention of cardiovascular disease in clinical practice. Heart 2005;91(suppl 5):v1-v52.[Free Full Text]
• Williams B., Poulter NR, Brown MJ et al. Guidelines for management of hypertension: report of the fourth working party of the British Hypertension Society, 2004-BHS IV. J Hum Hypertens 2004;18:139-85.[CrossRef][Web of Science][Medline] [Order article via Infotrieve]
• Barnett AH, O'Gara G. Diabetes and the heart. Churchill Livingstone, London, 2003.
• UK Prospective Diabetes Study (UKPDS) Group. Tight blood pressure control and risk of macrovascular and microvascular complications in type 2 diabetes: UKPDS 38. UK Prospective Diabetes Study Group. BMJ 1998;317:703-13.[Abstract/Free Full Text]
• UK Prospective Diabetes Study (UKPDS) Group. Intensive blood-glucose control with sulphonylureas or insulin compared with conventional treatment and risk of complications in patients with type 2 diabetes (UKPDS 33). Lancet 1998;352:837-53.[CrossRef][Web of Science][Medline] [Order article via Infotrieve]
• European Diabetes Policy Group. A desktop guide to type 2 diabetes mellitus. Diabet Med 1999;16:716-30.[CrossRef][Web of Science][Medline] [Order article via Infotrieve]
• Diabetes Update. Helping smokers to quit. Diabetes Update 2001; Fact Sheet 20. http://www.diabetes.org.uk/update/spring01/fact.htm:1-6 (Accessed 31 Aug 2006).
• International Diabetes Federation. Obesity and type 2 diabetes. International Diabetes Federation 2005;http://www.eatlas.idf.org/Obesity_and_type_2_diabetes/:1-4 (Accessed 31 Aug 2006).
• Dempsey C., McHoy A., Da Costa S. Planning and implementing a DSN clinic in primary care. Journal of Diabetes Nursing 2005;9:200-302.

The British Journal of Diabetes & Vascular Disease, Vol. 6, No. 2 suppl, S2-S6 (2006)
DOI: 10.1177/14746514060060020201


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This Article Abstract Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Alert me to new issues of the journal Add to Saved Citations Download to citation manager Request Permissions Request Reprints Add to My Marked Citations Citing Articles Citing Articles via Google Scholar Citing Articles via Scopus Google Scholar Articles by Da Costa, S. Search for Related Content Social Bookmarking                         What's this?