Outcomes of Care in NIDDM
The niddm port (patient outcomes Research Team) study is an observational study to examine outcomes of care among 1539 non-insulin dependent diabetics (mean age, 63).
Almost 40% of these patients were taking antihypertensive medications, and 7% were taking hypolipidemic agents. Although the mean hemoglobin A-1-C was 7.8%, almost half the patients had levels less than 7.1%. Mean total cholesterol was 229 mg/dL, and mean HDL was 43 mg/dL. The aggregate cardiovascular disease prevalence was 51%.
The prevalence of cardiovascular disease remained constant across increasing levels of glycohemoglobin for both women and men, and similarly, there was no relationship to random plasma glucose concentration. On the other hand, traditional cardiovascular risk factors (e.g., hypertension, smoking, hyperlipidemia, low HDL cholesterol) were shown to correlate with prevalence of cardiovascular disease.
The authors found no association between glycemic control (as measured by glycohemoglobin) and prevalence of cardiovascular disease in this population and suggest that intensive management of the known traditional risk factors for cardiovascular disease may be the most promising strategy to reduce cardiovascular complications in NIDDM.
Meigs J, et al. Am J Med 1997;102: 38-47.
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