Cardiovascular risk profile of type 2 diabetic patients cared for by general practitioners or at a diabetes clinic : A population-based study.
The aims of this study were to compare the cardiovascular risk profiles of patients with type 2 diabetes mellitus cared for by general practitioners and those regularly attending a diabetes center.
Out of an Italian population-based cohort of 1967 diabetic patients, 1574 (80%) were investigated.
Patients exclusively cared for by general practitioners (23.8%) were older and showed lower prevalence of hypertension (79.0% vs 85.9%, P<0.001), poor blood glucose control (HbAlc>8.0,33.4% vs 47.9%, P<0.001) and coronary heart disease (18.1% vs 22.3%, P=0.003), and lower plasma fibrinogen (3.5 ± 0.8 vs 3.7 ± 0.9 g/L, P<0.001).
In logistic regression analysis, they had significantly lower ORs for HbAlc>8.8% (OR 0.67,95% Cl 0.45-0.99), hypertension (OR 0.53,95% Cl 0.36-0.78), fibrinogen>4.1 g/L (OR 0.50,95% Cl 0.32-0.77), smoking (OR 0.60,95% Cl 0.36-1.00), and coronary heart disease (OR 0.65,95% Cl 0.45-0.93), after adjustment for age, sex, duration of diabetes, BMI, and antidiabetic treatment.
Patients regularly cared for at a diabetes clinic had a higher cardiovascular risk profile, suggesting selective referral to the clinics of patients with more difficult management and/or severity of the disease.
These findings have implications in the interpretation of morbidity and mortality clinic-based studies.
Mots-clés Pascal : Appareil circulatoire pathologie, Risque, Profil, Diabète, Néphropathie, Médecin généraliste, Service hospitalier, Italie, Europe, Prévalence, Complication, Homme, Epidémiologie, Etude comparative, Endocrinopathie, Appareil urinaire pathologie, Personnel sanitaire
Mots-clés Pascal anglais : Cardiovascular disease, Risk, Profile, Diabetes mellitus, Nephropathy, General practitioner, Hospital ward, Italy, Europe, Prevalence, Complication, Human, Epidemiology, Comparative study, Endocrinopathy, Urinary system disease, Health staff
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 99-0339772
Code Inist : 002B21E01B. Création : 14/12/1999.