Inadequate Control of Cardiovascular
Risk Factors
According to a National Health and Nutrition Examination Survey (NHANES), less than 10% of patients diagnosed with type 2 diabetes have the 3 major risk factors for the disease under control. These risk factors are:
- A1C level (goal is <7%)
- Blood pressure (goal is <130/80 mmHg)
- Total cholesterol level (goal is <200 mg/dL [5.18 mmol/L])
- LDL (“bad”) cholesterol (American Diabetes Association [ADA] goal is <100 mg/dL)
- HDL (“good”) cholesterol (ADA goal for men is >40 mg/DL; for women, >50 mg/dL)
- Triglycerides (ADA goal is <150 mg/dL)
It is generally accepted in the medical community that treatment of hyperglycemia, hypertension, and hyperlipidemia are critical, given that a significant percentage of diabetes patients ultimately die of cardiovascular disease.
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Putting education into practice
There is more to treating diabetes than keeping blood sugar levels within range. Responsible treatment also includes monitoring and treating total cholesterol, HDL cholesterol, LDL cholesterol, triglycerides, blood pressure, and weight.
There is ample evidence that people with diabetes can reduce diabetes complications by working to control the dominant risk factors of blood glucose, blood pressure, and blood lipids. In general:
- A percentage point drop in A1C can lower the risk of microvascular complications by 40%.
- For every 10 mmHg reduction in systolic blood pressure, the chance of complications related to diabetes is lowered by 12%.
- Increased control of LDL cholesterol can lower cardiovascular complications by 20% to 50%.
Attitudes toward diabetes education
According to a study by Golin et al, diabetes education plays a role in patients’ desire to participate in their health care decisions. Patients who were “younger” were more open to discuss self-management issues.
Generally, positive health outcomes are influenced by a patient’s own participation in his or her medical care and in decision making. But not all patients are interested in taking an active role in their health management. A study by Jahng et al revealed that positive patient outcomes tend to be higher when physicians and patients share the same belief about the value of patient participation and want increased patient involvement.
