Prevalence and therapy of cardiovascular risk factors in hospitalised type2 diabetics

Type 2 diabetes mellitus is often associated with other risk factors for at herosclerotic disease, resulting in a marked increase in cardiovascular eve nts and deaths. Combined treatment of hyperglycaemia, dyslipidaemia and hyp ertension significantly decreases the frequency and severity of diabetic mi crovascular and macrovascular complications. In a prospective cohort study including 356 type 2 diabetic patients (= 14% of all in-patients during a 6 months' period) the prevalence and treatment of cardiovascular risk factors were determined. Hypertension was diagnosed in 54% of the diabetic patients, albuminuria in 53% and dyslipidaemia in 4 7%; there were 40 smokers (17%). On admission the mean HbA(1c) was 7.7 +/- 2.0%, the mean fasting plasma glucose 10.0 +/- 4.2 mmol/l (and 8.9 +/- 3.9 mmol/l, p = 0.03, when discharged), the mean systolic blood pressure was 14 4 +/- 28 mm Hg (and 131 +/- 20, p <0.0001, when discharged), and the trigly cerides were 2.6 +/- 0.4 mmol/l. 34% of the hypertensive diabetic patients were treated with a combination of anti-hypertensive drugs, 44% of the dysl ipidaemic diabetic patients were treated with statins, and 58% of all diabe tic patients received aspirin or oral anticoagulation. 23% of the diabetic patients were treated by diet alone, 36% with insulin, 25% with sulfonylure as and 5% with metformin, while 11% were given a combination of antihypergl ycaemic medication. In-hospital mortality was 11%. The diabetic patients we re discharged on 2.9 +/- 1.7 different drugs. The prevalence of associated cardiovascular risk factors is high in type 2 diabetic patients, and thus a combination of drugs is often warranted. The rate of admissions and in-hospital mortality is high in type 2 diabetic pat ients.