Endocrine Abstracts (2009) 20 P419

Type 2 diabetes mellitus: failure to recognize cardiovascular risk jeopardizes prevention of diabetes complications in type 2 diabetic patients in daily practice

Eckart Jungmann & Gisela Jungmann

St Vincent’s Hospital, D-33378 Rheda-Wiedenbrück, Germany.

There are still considerable deficits in the prevention of cardiovascular diabetes complications as in effective antihypertensive treatment in type 2 diabetic patients in daily practice. There is controversy, however, to which extent lack of information regarding potential risk factors or deficits in disease awareness of the patients themselves contributes to this unfavourable situation.

In 45 female and 51 male type 2 diabetic patients, age, 56+16 years (mean+S.E.M.), known duration of diabetes, 10+11 years, who were referred to our institution by their general practitioners for start or optimization of insulin therapy, we assessed the knowledge concerning risk markers and chances of prevention of cardiovascular diabetes complications.

Patients who were aware of risk markers had lower levels of cholesterol and triglyceride (P<0.05) as well as urinary albumin excretion than patients without this awareness, but blood pressure levels were not different. Awareness of the significance of hypertension was most prevalent (55%, P<0.05), but self-reported blood pressure levels were considerably lower than measured blood pressure (P<0.05). Although 70% of the patients knew about the significance of treatment with thrombocyte aggregation inhibitors, only 29% of the patients were treated by aspirin or clopidogrel (P<0.05).

Lack of information, wrong beliefs and the ‘behaviour gap’, the difference between the informations the patients have about their disease and what they actually do, contribute to insufficient prevention of cardiovascular risk and disease complications in patients with type 2 diabetes in daily practice. More concerted efforts are required to improve the quality of teaching of all type 2 diabetic patients by competent diabetes teachers and to increase disease awareness and, hopefully, cardiovascular outcome of the patients.

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