Investigation of cardiovascular risk factors in type 2 diabetes in a rural Australian Division of General Practice

Abstract

To examine the changes in cardiovascular disease (CVD) risk factors for a cohort of patients with type 2 diabetes in general practice. A 4-year retrospective cohort study using extracted data from an active Division of General Practice diabetes register in Australia. 628 patients (297 female; 331 male) with type 2 diabetes who participated in the diabetes program of the Southern Highlands Division of General Practice and for whom evaluation data were recorded each year from 2002 to 2005. Changes in the following CVD risk factors over time: body mass index (BMI), serum lipid levels (total cholesterol [TC], low-density lipoprotein cholesterol [LDL-C], high-density lipoprotein cholesterol [HDL-C], total triglycerides [TG]), systolic and diastolic blood pressure (BP), and glycated haemoglobin (HbA(1c)) level. After adjusting for age, sex, duration and clustering, there was significant improvement in serum lipid levels (TC and LDL-C; P < 0.05) over time; and there was no significant change in BP, HbA(1c) level or BMI. Older patients had significantly worse systolic BP, but significantly better BMI and lipid levels than younger patients. Longer duration of diabetes was associated with worse systolic BP and HbA(1c) level, but better HDL-C level. People with higher BMI were likely to have worse systolic BP, and HDL-C and HbA(1c) levels, but better TC level than those with lower BMI. Improving BP, HbA(1c) level and BMI may be more difficult than improving lipid levels. There is a need for more intensive and comprehensive interventions to reduce the total risk of CVD.