Are the new Joint British Societies 2 (JBS 2) targets achievable?

Abstract

AbstractThe Joint British Societies 2 (JBS 2) guidelines suggest targets for glycated haemoglobin (HbA1c) (≤6.5%), blood pressure (≤130/80mmHg), total cholesterol (≤4.0mmol/L), and aspirin therapy in patients with diabetes. The aim of this survey was to determine whether patients attending a hospital new patient diabetes clinic achieved these targets one year after referral.We conducted a review of electronic diabetes and primary care records of all patients attending a single consultant‐led new patient diabetes clinic between 1 January and 31 December 2004. Demographic and clinical data at first visit and one year later (HbA1c, blood pressure, total cholesterol, aspirin prescribing) were obtained.In total, 259 patients had full data. The results at one‐year follow up showed: an HbA1c median reduction of ‐1.6% (64.9% achieving HbA1c reduction ≥1%, 54.1% achieving HbA1c ≤7.5%, 20.1% achieving HbA1c ≤6.5%); a median blood pressure reduction of ‐10/6mmHg (81.5% achieving systolic blood pressure [SBP] ≤140mmHg, 43.6% achieving SBP ≤130mmHg); and a median reduction in total cholesterol ‐1.2mmol/L (78.4% achieving total cholesterol ≤5.0mmol/L, 64.1% achieving total cholesterol ≤4.0mmol/L). Aspirin prescribing did not increase between the two visits.It was concluded that improvements in cardiovascular risk factors can be achieved in a hospital diabetic clinic setting, although attainment of targets suggested by the recent JBS 2 guidelines, particularly for glycaemic control and aspirin prescribing, requires significant further effort. Copyright © 2006 John Wiley & Sons, Ltd.