When Managing Diabetes, Good Glycemic Control Is Not Enough

June 17, 2002 —

When it comes to managing diabetes, doctors may achieve good glycemic control but have a lower priority for controlling or treating other cardiovascular risk factors, according to two presentations June 15 at the annual American Diabetic Association meeting.


"An opportunity exists to improve treatment rates and goal attainment for glycemic, lipid, and blood pressure control among patients with diabetes," write Richard Bergenstal, from the International Diabetes Center in Minneapolis, Minnesota, and colleagues.

"Only by understanding how physicians prioritize and address these risk factors will we be able to develop more effective strategies to reach goals and reduce the burden of cardiovascular disease in diabetes."


This 12-month, multicenter, observational study was one of the first and largest prospective studies to investigate how clinicians approach major cardiovascular risk factors and how this approach ultimately affects HbA1c, blood pressure, and low-density lipoprotein (LDL) cholesterol. About 2,300 newly referred or newly diagnosed diabetes patients, aged 40 years and older, were enrolled from 144 sites. Mean age was 61 years, and 87% of patients had type 2 diabetes.

Baseline medications included glycemic therapy in 70%, antihypertensives in 67%, and lipid-lowering therapy in 44%. The percentage of patients meeting goal at baseline was 33.5% for HbA1c, 30.4% for LDL cholesterol, and 17.6% for blood pressure. "Physicians indicated a primary focus on.

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