Achievement of treatment goals for secondary prevention of myocardial infarction or stroke in 29,325 patients with type 2 diabetes: a German/Austrian DPV-multicenter analysis

Abstract

BackgroundTo analyze whether medical care is in accordance with guidelines for secondary prevention of myocardial infarction (MI), or stroke in patients with type 2 diabetes from Germany and Austria.Methods29,325 patients (≥20 years of age) with type 2 diabetes and MI, or stroke, documented between 2006 and 2015 were selected from the Diabetes-Patienten-Verlaufsdokumentation database. We analyzed medication, clinical characteristics, and lifestyle factors according to national secondary prevention guidelines in patients with MI, or stroke, separately.ResultsHbA1C <7.5 % was achieved in 64.9 % (MI), and in 61.1 % (stroke) of patients. LDL <100 mg/dl was documented in 56.2 % (MI), and in 42.2 % (stroke). Non-smoking was reported in 92.0 % (MI), and in 93.1 % (stroke), physical activity in 9.6 % (MI), and 5.5 % (stroke). Target values of blood pressure (<130/80 mmHg in MI, 120/70–140/90 in stroke) were reached in 67.0 % (MI), and in 89.9 % (stroke). Prescription prevalence of inhibitors of platelet aggregation (IPA) was 50.7 % (MI), and 31.7 % (stroke). 57.0 % (MI), and 40.1 % (stroke) used statins, 65.1 % (MI), and 65.8 % (stroke) used any type of antihypertensives, and ACE inhibitors were prescribed in 49.7 % (MI), and 41.3 % (stroke). A body mass index (BMI) <27 kg/m2 and the use of beta blockers were only recommended in subjects with MI. Of the patients with MI, 32.0 % had a BMI <27 kg/m2, and 59.5 % used beta blockers.ConclusionsAchievement of treatment goals in secondary prevention of MI, or stroke in subjects with type 2 diabetes needs improvement. Target goals were met more frequently in patients with MI compared to subjects with stroke. Especially the use of IPA was very low in patients with stroke. There remains great potential to reduce the risk of repeated macrovascular events and premature death, as well as to increase patients’ quality of life.

Regional differences in type 2 diabetes treatment and outcomes in Germany—An analysis of the German DPV and DIVE registries

“…The study protocol was approved by the ethics committee of the Medical School of Hannover (process number 6003). The DPV database was established in Germany in 1995 at Ulm University . Approximately 450 centres in Germany currently use the DPV software.…”

“…The DPV database was established in Germany in 1995 at Ulm University. [17][18][19] Approximately 450 centres in Germany currently use the DPV software. Every 6 months, locally documented data are anonymized and sent to the University of Ulm.…”

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Spectrophotometry and Ultracentrifugation for Measurement of Plasma Lipids in Dogs with Diabetes Mellitus

“…It is therefore concluded that increases in both LDL‐C and non‐HDL‐C are important in dyslipidemia of dogs with DM. LDL‐C and non‐HDL‐C are major causative predictors of cardiovascular disease in humans and the goal of lipid‐lowering treatment in humans with type 1 or type 2 DM is to decrease LDL‐C and non‐HDL‐C to less than 100 mg/dL and 130 mg/dL, respectively . It is not known whether these target lipid concentrations are important in dogs with DM, because atherosclerosis and cardiovascular disease in dogs with DM are rare .…”