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Cardiovascular risk factors and metabolic control in type 2 diabetic subjects attending outpatient clinics in Italy: the SFIDA (survey of risk factors in Italian diabetic subjects by AMD) study.

Abstract

BACKGROUND AND AIM

To perform an observational, cross-sectional study aiming to assess multiple cardiovascular risk factors and metabolic control in a very large and representative sample of type 2 diabetic subjects attending diabetes outpatient clinics (DOCs) in Italy.

METHODS AND RESULTS

Two hundred and sixty-one clinics were involved, representing about one-third of the whole number of DOCs in the Country. Each clinic recruited on a random basis from 50 to 100 type 2 diabetic patients aged 35-70 years, diagnosed more than six months before the start of the study. Demographic and clinical data were collected and blood pressure, lipids, HbA(1c), fasting blood glucose (FBG), and microalbuminuria were measured. Overall, 12,222 type 2 diabetic patients were recruited in 253 DOCs. Female subjects showed higher FBG, HbA 1c, blood pressure, lipid levels, and a longer duration of disease. The proportion of patients with BMI > or = 30 was 33.3% among males and 45.9% among females; 40.9% of male patients had a waist circumference greater than 102 cm, while 79% of female patients had a waist circumference over 88 cm. More than two-third of the patients (74.4%) had systolic blood pressure values of > or = 130 mmHg, and one-third (33.2%) had diastolic values > or = 85 mmHg. The mean value of HbA(1c) was 7.6+/-1.6, and 23.7% of the observed population had an HbA 1c level > 8.5%. More than half of the study population had total cholesterol levels > or = 5.2 mmol/l, 47% had LDL cholesterol values of 3.3 mmol/l or greater and 9.6% had HDL cholesterol level lower than 0.90 mmol/l. The presence of multiple lipid alterations was associated with markedly higher HbA 1c levels, in both subjects treated with lipid lowering drugs and untreated subjects. Finally, even moderate increases in HbA 1c levels (i.e. HbA 1c > 7.5%) were associated with a statistically significant greater risk of systolic blood pressure levels > or = 160 mmHg in women (OR = 1.40; 95% CI 1.09-1.80) but not in men (OR = 1.21; 95% CI 0.96-1.54).

CONCLUSIONS

The SFIDA study provides a clear indication of the need to orient diabetes care towards the control of global cardiovascular risk. Only a stricter adherence to the existing guidelines and a much stronger attention to the attainment of the desired therapeutic goals will allow a decrease in morbidity and mortality as well as in the costs related to diabetes.

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  • Authors+Show Affiliations

    ,

    Department of Internal Medicine, West Genoa Hospital, Genova, Italy. m.comaschi.usl3@libero.it

    , , , , ,

    Source

    MeSH

    Adult
    Aged
    Blood Glucose
    Body Mass Index
    Cardiovascular Diseases
    Cross-Sectional Studies
    Diabetes Mellitus, Type 2
    Female
    Glycated Hemoglobin A
    Humans
    Hypertension
    Italy
    Male
    Middle Aged
    Obesity
    Risk Factors
    Sex Factors

    Pub Type(s)

    Journal Article
    Multicenter Study
    Research Support, Non-U.S. Gov't

    Language

    eng

    PubMed ID

    15955469

    Citation

    Comaschi, Marco, et al. "Cardiovascular Risk Factors and Metabolic Control in Type 2 Diabetic Subjects Attending Outpatient Clinics in Italy: the SFIDA (survey of Risk Factors in Italian Diabetic Subjects By AMD) Study." Nutrition, Metabolism, and Cardiovascular Diseases : NMCD, vol. 15, no. 3, 2005, pp. 204-11.
    Comaschi M, Coscelli C, Cucinotta D, et al. Cardiovascular risk factors and metabolic control in type 2 diabetic subjects attending outpatient clinics in Italy: the SFIDA (survey of risk factors in Italian diabetic subjects by AMD) study. Nutr Metab Cardiovasc Dis. 2005;15(3):204-11.
    Comaschi, M., Coscelli, C., Cucinotta, D., Malini, P., Manzato, E., & Nicolucci, A. (2005). Cardiovascular risk factors and metabolic control in type 2 diabetic subjects attending outpatient clinics in Italy: the SFIDA (survey of risk factors in Italian diabetic subjects by AMD) study. Nutrition, Metabolism, and Cardiovascular Diseases : NMCD, 15(3), pp. 204-11.
    Comaschi M, et al. Cardiovascular Risk Factors and Metabolic Control in Type 2 Diabetic Subjects Attending Outpatient Clinics in Italy: the SFIDA (survey of Risk Factors in Italian Diabetic Subjects By AMD) Study. Nutr Metab Cardiovasc Dis. 2005;15(3):204-11. PubMed PMID: 15955469.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Cardiovascular risk factors and metabolic control in type 2 diabetic subjects attending outpatient clinics in Italy: the SFIDA (survey of risk factors in Italian diabetic subjects by AMD) study. AU - Comaschi,Marco, AU - Coscelli,Carlo, AU - Cucinotta,Domenico, AU - Malini,Pierluigi, AU - Manzato,Enzo, AU - Nicolucci,Antonio, AU - ,, PY - 2004/02/17/received PY - 2004/06/18/revised PY - 2004/07/27/accepted PY - 2005/6/16/pubmed PY - 2005/10/21/medline PY - 2005/6/16/entrez SP - 204 EP - 11 JF - Nutrition, metabolism, and cardiovascular diseases : NMCD JO - Nutr Metab Cardiovasc Dis VL - 15 IS - 3 N2 - BACKGROUND AND AIM: To perform an observational, cross-sectional study aiming to assess multiple cardiovascular risk factors and metabolic control in a very large and representative sample of type 2 diabetic subjects attending diabetes outpatient clinics (DOCs) in Italy. METHODS AND RESULTS: Two hundred and sixty-one clinics were involved, representing about one-third of the whole number of DOCs in the Country. Each clinic recruited on a random basis from 50 to 100 type 2 diabetic patients aged 35-70 years, diagnosed more than six months before the start of the study. Demographic and clinical data were collected and blood pressure, lipids, HbA(1c), fasting blood glucose (FBG), and microalbuminuria were measured. Overall, 12,222 type 2 diabetic patients were recruited in 253 DOCs. Female subjects showed higher FBG, HbA 1c, blood pressure, lipid levels, and a longer duration of disease. The proportion of patients with BMI > or = 30 was 33.3% among males and 45.9% among females; 40.9% of male patients had a waist circumference greater than 102 cm, while 79% of female patients had a waist circumference over 88 cm. More than two-third of the patients (74.4%) had systolic blood pressure values of > or = 130 mmHg, and one-third (33.2%) had diastolic values > or = 85 mmHg. The mean value of HbA(1c) was 7.6+/-1.6, and 23.7% of the observed population had an HbA 1c level > 8.5%. More than half of the study population had total cholesterol levels > or = 5.2 mmol/l, 47% had LDL cholesterol values of 3.3 mmol/l or greater and 9.6% had HDL cholesterol level lower than 0.90 mmol/l. The presence of multiple lipid alterations was associated with markedly higher HbA 1c levels, in both subjects treated with lipid lowering drugs and untreated subjects. Finally, even moderate increases in HbA 1c levels (i.e. HbA 1c > 7.5%) were associated with a statistically significant greater risk of systolic blood pressure levels > or = 160 mmHg in women (OR = 1.40; 95% CI 1.09-1.80) but not in men (OR = 1.21; 95% CI 0.96-1.54). CONCLUSIONS: The SFIDA study provides a clear indication of the need to orient diabetes care towards the control of global cardiovascular risk. Only a stricter adherence to the existing guidelines and a much stronger attention to the attainment of the desired therapeutic goals will allow a decrease in morbidity and mortality as well as in the costs related to diabetes. SN - 0939-4753 UR - https://www.unboundmedicine.com/medline/citation/15955469/Cardiovascular_risk_factors_and_metabolic_control_in_type_2_diabetic_subjects_attending_outpatient_clinics_in_Italy:_the_SFIDA__survey_of_risk_factors_in_Italian_diabetic_subjects_by_AMD__study_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0939-4753(05)00042-6 DB - PRIME DP - Unbound Medicine ER -