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Item #8.
Diabetics
Need Greater Awareness Of Cardiovascular Risk Factors
Adults
with diabetes mellitus have a high prevalence of modifiable
cardiovascular disease (CVD) risk factors but often are not
counseled by doctors on how to change their lifestyles.
"There
is a need to improve patient counseling for lifestyle modification
by primary-care physicians," United States researchers say.
"Although adults with diabetes mellitus have a high
prevalence of modifiable CVD risk factors, counseling by
physicians about lifestyle modification is less than
optimal."
Investigators from the Medical University of South Carolina in
Charleston say adult diabetics are more likely to have modifiable
risk factors than are non-diabetic adults that differ by
ethnicity, sex and age. "There is a need for primary care
physicians to recognize the prevalence of modifiable CVD risk
factors among adults with DM," they suggest.
"Recognizing the pattern in which these CVD risk factors
cluster in people with DM may improve identification of high-risk
patients."
Researchers say lack of counseling "may suggest that
strategies to improve counseling techniques in primary care are
needed, especially on how to counsel patients to modify high-risk
behavior? There may be benefit in incorporating counseling skills
into medical residency education or as continuing medical
education activity for primary-care physicians."
Investigators analyzed data on 9,496 diabetic adults and 150,493
non-diabetics for estimates of both CVD risk factors and
counseling by doctors during routine medical visits. Data came
from the 1999 US Behavioral Risk Factor Surveillance System.
"Diabetes mellitus was more prevalent in adults aged 55 and
older and in blacks and Hispanic or other ethnicities," they
report. "Modifiable CVD risk factors such as hypertension,
high cholesterol, obesity and insufficient physical activity were
more prevalent in adults with diabetes mellitus and differed by
ethnicity, sex and age."
Hypertension prevalence was 56 percent in diabetics, compared to
22 percent in non-diabetics. High cholesterol was found in 41
percent of diabetics and only 20 percent of non-diabetics.
Approximately 78 percent of diabetics were obese, compared with 57
percent of non-diabetics.
"Counseling about weight loss, smoking cessation, eating less
fat and increasing physical activity was less than ideal in both
groups and did not change after adjusting for age, sex, ethnicity,
education and income," researchers add.
They point out that distributions of ethnicity, sex and age among
diabetic adults included in the study were consistent with those
of previous diabetes studies.
"Finding of a higher prevalence of modifiable CVD risk
factors among people with diabetes mellitus is not
surprising," investigators suggest.
"Clustering in certain individuals of diabetes, hypertension,
high cholesterol and obesity - known as the metabolic
cardiovascular syndrome or the 'deadly quartet' - has been
described." Archives of Internal Medicine, 2002; 162:
427-433.
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Did
You Know:
Nearly
18.4% of the United States population or 6.3 million people age 65
and older have diabetes.
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