RT Journal Article
SR Electronic
T1 Exploring the relationship between coronary heart disease and type 2 diabetes: a cross-sectional study of secondary prevention among diabetes patients
JF BJGP Open
JO BJGP Open
FD Royal College of General Practitioners
SP bjgpopen18X101636
DO 10.3399/bjgpopen18X101636
VO 3
IS 1
A1 Gjelsvik, Bjørn
A1 Tran, Anh Thi
A1 Berg, Tore J
A1 Bakke, Åsne
A1 Mdala, Ibrahimu
A1 Nøkleby, Kjersti
A1 Cooper, John G
A1 Claudi, Tor
A1 Løvaas, Karianne Fjeld
A1 Thue, Geir
A1 Sandberg, Sverre
A1 Jenum, Anne K
YR 2019
UL http://bjgpopen.org/content/3/1/bjgpopen18X101636.abstract
AB Background Coronary heart disease (CHD) and stroke are the major causes of death among people with diabetes.Aim To describe the prevalence and onset of CHD and stroke among patients with type 2 diabetes mellitus (T2DM) in primary care in Norway, and explore the quality of secondary prevention.Design & setting A cross-sectional study of data was undertaken from electronic medical records (EMRs) of 10 255 patients with T2DM in general practice. The study took place in five counties of Norway (Oslo, Akershus, Rogaland, Hordaland, and Nordland). Quality of care was assessed based on national guideline recommendations.Method Summary statistics with adjustments and binary logistic regression models were used.Results In total, 2260 patients (22.1%) had CHD and 759 (7.4%) had stroke. South Asians had significantly more CHD than ethnic Norwegians (29.5%, 95% confidence interval [CI] = 26.1 to 33.0 versus 21.5%, CI = 20.6 to 22.3) and other ethnic groups, and experienced onset of CHD or stroke at a mean of 7 years before Norwegians. In 47.9% of the patients, CHD was diagnosed before T2DM. Treatment target for low-density lipoprotein (LDL) cholesterol was reached for 30.0% and for systolic blood pressure (SBP) for 65.1% of the patients with CHD. Further, 20.9% of patients with CHD were present smokers, and only 5.0% of patients reached all four treatment targets (no smoking, HbA1c ≤7.0%, SBP <135 mmHg, LDL-cholesterol <1.8 mmol/l).Conclusion The diagnosis of CHD preceded the diagnosis of T2DM in half of the patients. The prevalence of CHD was highest and onset earlier among ethnic South Asians. More intensive treatment of lipids, blood pressure, and smoking are needed in patients with T2DM and CHD.