The relationship between diabetes and increased risk of mortality from cardiovascular disease (CVD) is well established. What opportunities still remain in general practice to identify at risk patients and optimise their management?
In Australia almost two-thirds of the people who die from cardiovascular disease (CVD) also have diabetes or pre-diabetes.1
Risk factors for CVD such as hypertension and dyslipidaemia are commonly observed in people diagnosed with type 2 diabetes, and diabetes itself confers independent elevated CVD risk.2
Managing multiple CV risk factors rather than treating individual risk factors alone is encouraged, and is a crucial part of diabetes care.3,4 Alongside tight glycaemic control, guidelines recommend that patients with both type 2 diabetes and a history of established CVD be simultaneously treated with an antiplatelet (or anticoagulant), lipid-lowering and blood pressure (BP)-lowering therapy.3,4
However, despite the significantly elevated risk, studies in Australian primary care have reported that
- patients with diabetes do not meet guideline recommended treatment targets for managing cardiovascular risk and
- prescribing of recommended medicines for this patient cohort is suboptimal.5
In addition to pharmacological management, people with diabetes require continuous and systematic monitoring of blood glucose, BP, lipid and renal function targets to help direct management strategies, and detect diabetes complications.4