ECE2013 Poster Presentations Diabetes (151 abstracts)
Hospital Virgen Macarena, Seville, Spain.
Objective: To analyze the impact of a specialized management on cardiovascular risk at the onset of type 2 diabetes mellitus.
Material and method: Were analyzed 171 patients who visited our diabetes day hospital (DDH) during 20102011, studying the following variables: sex, age, BMI, smoking habit, arterial hypertension (de novo/previously known), antihypertensive therapy, dislypidemia (de novo/previously known), hypolipidemic therapy, antidiabetic therapy and antithrombotic therapy. Furthermore, were measured other variables at the onset and 3 months after diagnosis of type 2 diabetes mellitus, using the paired Students t-test (SPSSv18.0). The cardiovascular risk calculator (UKPDS RISK ENGINE) was also performed initially and after three months of monitoring.
Results: The sample included 121 men (70.8%) and 50 women (29.2%), with an average age of 53.6±12.6 years old. They showed a BMI of 31.6±6.2 kg/m2. A 40.9% of them were smokers while 14.6% were previously smokers and 44.4% non-smokers. An associated arterial hypertension was present in a 61.4% of patients (32% de novo and 68% previously known)and 48% were treated with a single agent, 39% with two agents and 6.4% with three agents. Regarding to hyperlypidemia it was observed in 72.5% (72.5% de novo, 28.5% previously known). According to the antidiabetic therapy we obtain the following data: oral monotherapy (17.4%), double oral therapy (31.1%), triple oral therapy (0.6%), basal insulin (9.6%), pre-mixed insulin (11.9%) and basal-bolus (29.3%). A 66% of patients used antiaggregation or anticoagulation (acetylsalicylic acid 91%, oral anticoagulation 4.4%, double antiaggregation 4.5%).
HbA1c | Weight | DBP | TAD | LDLc | TG | HDLc | |
Initial | 10.6±2.4 | 88.2±19.3 | 137±19 | 78±13 | 126±39 | 329±54 | 40±13 |
Final | 6.4±1.1 | 87.7±17.9 | 133.6±20 | 75±11 | 100±37 | 140±86 | 44±14 |
P<0.05 | NS | NS | NS | P<0.05 | P<0.05 | P<0.05 |
UKPDS risk engine | CHD | Fatal CHD | Stroke | Fatal stroke | |
Men | Initial | 26.4 | 14.6 | 3.5 | 0.4 |
Final | 12.0 | 4.8 | 3.3 | 0.4 | |
Women | Initial | 17.0 | 11.1 | 4.3 | 0.6 |
Final | 7.9 | 4.1 | 3.9 | 0.5 |
Conclusions: It is essential the development of functional units to perform an education for health combined with a comprehensive and an intensive management of the associated diseases and risk factors present at the onset of type 2 diabetes mellitus, regarding to the determining clinical benefit which is obtained.