Diet and medication adherence can reduce cardiovascular disease for patients with type 2 diabetes
Research Activities, April 2011, No. 368
Cardiovascular disease (CVD) is a serious but preventable complication of type 2 diabetes. Managing the numerous risk factors responsible for CVD in people with diabetes is an ongoing challenge for primary care clinicians. A new study found that the mean 10-year risk of CVD in this group was 16.2 percent. Yet nearly one-third of this total risk was attributable to factors such as high cholesterol, hypertension, and smoking, which can be modified with diet, exercise, smoking cessation, and medication adherence. For example, patients who reported good management of their diets and adherence to prescribed medication regimens lowered their mean risk of any cardiovascular event, such as a stroke or heart attack, by 44 and 39 percent, respectively.
The researchers examined the prevalence of CVD risk factors (elevated glycated hemoglobin or HbA1c levels, hypertension, high cholesterol, and smoking status), the attributable risk owing to these factors, and the association between attributable risk of CVD and diet, exercise, and medication adherence. The study population consisted of 313 patients with CVD who were being treated at 20 primary health care clinics in South Texas.
The primary driver of modifiable risk reduction was HbA1c levels (an indicator of blood-glucose control), accounting for nearly two-thirds of the decrease in attributable risk. The next biggest contributors were lipid levels and smoking status. The researchers conclude that high-quality diabetes care requires targeting modifiable patient factors strongly associated with CVD risk, including self-management behavior such as diet and medication adherence. This study was supported by the Agency for Healthcare Research and Quality (HS13008).
See "Cardiovascular disease in type 2 diabetes," by John Zeber, Ph.D., and Michael L. Parchman, M.D., in Canadian Family Physician 56, pp. e302-e307, 2010.