Endocrine Abstracts

Background and aims: Cardiovascular disease (CVD) is a leading causes of death in type 2 diabetes mellitus (T2DM), thus prevention of CVD is of utmost importance. Our aim was to determine whether the ESC/EASD guidelines on CVD prevention in T2DM patients are followed in clinical practice in Georgia.

Materials and methods: In total, 824 T2DM patients (age <80 yrs) with no history of coronary or other atherosclerotic disease, who entered Georgian Diabetes Center in 2009–2010 were included in a retrospective study. Data collection was based on a review of Patients’ Medical Notes, and interviews and examinations during at least six months post drug therapy initiation.

Results: Only 46.9% of patients had HbA1c <6.5%; 67.3% had average blood pressure (BP) ≥ 130/80 mmHg. Only 27.8% of patients on antihypertensive medications achieved BP goals; 74.7% had total cholesterol (TC) ≧4.5 mmol/l; out of all patients on lipid lowering therapy 67.7% achieved TC, 38.8% - triglycerides and 37.9% HDL-C goals. Following cardioprotective medications were used: aspirin or other anti-platelets - in 37.3% of patients, ACE inhibitors/ARB - in 61.5%, beta-blockers - in 27.1%, calcium channel blockers - in 33.5% and statins in 37.4% of patients.

Conclusion: Our study shows that glucose, blood pressure and lipid control are completely inadequate in a large majority of T2DM patients in Georgia; targets defined in the prevention ESC/EASD guidelines are not achieved. To some extent it is due to the fact that part of the patients quits or changes prescribed antihypertensive and/or lipid-lowering therapy. The fact that in patients on statin therapy triglycerides and HDL-C levels, when compared to TC ones, were mostly poorly controlled indicates to the necessity of administering additional agents to achieve target levels of lipids. Primary prevention needs systematic approach to therapeutic management that addresses various risk factors, and health care system that invests in prevention.

Declaration of interest: The authors declare that there is no conflict of interest that could be perceived as prejudicing the impartiality of the research project.

Funding: This research did not receive any specific grant from any funding agency in the public, commercial or not-for-profit sector.