On target? Cardiovascular risk factor patterns in type 1 and type 2 diabetes: real-world attainment of cardiovascular risk factor targets and medication prescriptions

Diabetes Research and Clinical Practice, vol. 239, pp. 113440

Abstract

AIMS: Adequate cardiovascular risk control prevents complications. A multifactorial approach for simultaneously managing risk factors is recommended by guidelines. We evaluated cardiovascular risk factors among Dutch diabetes outpatients and described glucose-lowering and cardiovascular prescriptions. METHODS: From the Dutch Pediatric and Adult Registry of Diabetes (DPARD), a cohort of 81,096 patients with type 1 diabetes (T1D) or type 2 diabetes (T2D) was derived from 2017 to 2024. Descriptive statistics reported patient characteristics and the primary outcomes cardiovascular risk targets and medication prescription patterns. RESULTS: Overall, 3,832 children had T1D, 145 children had T2D, 35,934 adults had T1D and 41,185 adults had T2D. For most cardiovascular risk factors, guideline-recommended targets were met by at least two-thirds of patients, whereas some risk factors had lower attainment in specific subgroups. HbA1c was the least frequently reached target. The most common medications for T1D were fast-acting and long-acting insulins. For T2D, these were biguanides, insulins, sulfonylureas, GLP-1 agonists, and SGLT2 inhibitors. CONCLUSIONS: This study shows the extent to which guideline-recommended cardiovascular risk factor targets are met in children and adults with T1D and T2D, which varies by age group and diabetes type. These findings may refine individually tailored strategies for management of risk factors, particularly HbA1c.

Authors 12

1. Vivienne F. Lit Aachen

   Leiden University · Leiden University Medical Center · Dutch Institute for Clinical Auditing

   Affiliation as printed

   Leiden University Medical Centre, Leiden, the Netherlands; Dutch Institute for Clinical Auditing, Leiden, the Netherlands

2. Jessica C. G. Bak

   Radboud University Medical Center

   Affiliation as printed

   Radboud University Medical Centre, Nijmegen, the Netherlands

3. Arianne C. van Bon

   Rijnstate Hospital

   Affiliation as printed

   Rijnstate Hospital, Arnhem, the Netherlands

4. Erik H. Serné

   Amsterdam University Medical Centers

   Affiliation as printed

   Amsterdam University Medical Centre, Amsterdam, the Netherlands

5. Karlijn Sijstermans

   OLVG

   Affiliation as printed

   Onze Lieve Vrouwe Gasthuis, Amsterdam, the Netherlands

6. Catherline B. Brouwer

   OLVG

   Affiliation as printed

   Onze Lieve Vrouwe Gasthuis, Amsterdam, the Netherlands

7. Ingo A. Eland

   St. Antonius Ziekenhuis

   Affiliation as printed

   St Antonius Hospital, Nieuwegein, the Netherlands

8. Pauline J.H.M. Stouthart

   Zuyderland Medisch Centrum

   Affiliation as printed

   Zuyderland Hospital, Sittard, the Netherlands

9. Thomas van Bemmel

   Gelre Hospitals

   Affiliation as printed

   Gelre Hospitals, Apeldoorn, the Netherlands

10. Rolf H. H. Groenwold Aachen

    Leiden University · Leiden University Medical Center

    Affiliation as printed

    Leiden University Medical Centre, Leiden, the Netherlands

11. Theo Sas

    Erasmus MC · Erasmus MC - Sophia Children’s Hospital · Erasmus University Rotterdam

    Affiliation as printed

    Diabeter, Center for Pediatric and Adult Diabetes Care and Research, Rotterdam, the Netherlands; Erasmus University Medical Centre, Sophia Children's Hospital, Rotterdam, the Netherlands

12. Carianne L. Verheugt Aachen

    Leiden University · Leiden University Medical Center

    Affiliation as printed

    Leiden University Medical Centre, Leiden, the Netherlands. Electronic address: c.l.verheugt@lumc.nl