Preventing heart attacks and strokes in type 2 diabetes patients managed in primary care should be an urgent priority because most of the patients are at high risk of fatal heart attack or stroke, a study by Medical press has revealed.
The study was published on World Diabetes Day in the European Journal of Preventive Cardiology, a journal of the European Society of Cardiology (ESC).
Nigeria recently joined the rest of the world to celebrate the 2020 World Diabetes Day with the theme, ‘The Nurse and Diabetes’. The World Health Organisation (WHO) Nigeria Country profile report estimates that eight million Nigerians live with diabetes.
A general practitioner for the Catalan Institute of Health in Sant Adrià de Besòs, Dr. Manel Mata-Cases, said the most striking result of their study was that the vast majority of patients (93%) had a high or very high risk of fatal events within a decade.
Half of the patients in the very high-risk group had no history of heart disease, meaning they would not be receiving medications to prevent heart attacks and strokes,” said study author.
He said it was a cross-sectional study that used the Information System for the Development of Research in Primary Care (SIDIAP) database, which includes 74% of the total population in Catalonia, Spain adding that the SIDIAP database contains anonymous, longitudinal patient information extracted from the electronic medical record system (e-CAP) used by all primary health providers in Catalonia.
“The study population consisted of 373,185 people aged 18 and over with a diagnosis of type 2 diabetes by 31 December 2016. The average age was 70.1 years and 45.2% were female. Some 72% had high blood pressure, 45% were obese, 60% had high serum cholesterol, and 14% were current smokers.
He also said, to be classified as very high risk, patients must have established cardiovascular disease (e.g. prior heart attack or stroke), or other conditions which threaten their health such as kidney impairment, or at least three cardiovascular risk factors (older age, high blood pressure, high serum cholesterol, smoking, obesity).
Dr. Mata-Cases concluded that these findings in a primary care setting should fuel the implementation of integrated care.
“Healthy behaviours are the cornerstone of preventing cardiovascular disease and need to be combined with control of blood glucose, serum cholesterol, and blood pressure.
“GPs and nurses should agree on treatment objectives with patients considering their characteristics and preferences,” he said.
The study gave the following lifestyle advice for patients with diabetes:
– Quit smoking.
– Reduce calorie intake to lower excessive body weight.
– Adopt a Mediterranean diet supplemented with olive oil and/or nuts.
– Avoid alcohol.
– Do moderate-to-vigorous physical activity for at least 150 minutes per week.
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