Issue 118 Item 5 Diabetes Management in Cardiology Practices – Substandard

Cardiologists need to become more involved in managing hyperglycemia in patients with overt or latent diabetes, say researchers from the United States. They reviewed the charts of patients, who died January 1995 to December 1997, to determine how well cardiologists help patients manage their hyperglycemia.

To determine the prevalence of hyperglycemia and diabetes and to assess whether they had been managed according to established clinical guidelines, Dr. Samer Jabbour, of the Lown Cardiovascular Center and Harvard Medical School, Brookline, Massachusetts, and colleagues reviewed the medical records of patients who died in an academic outpatient cardiology practice from January 1995 to December 1997.

The investigators found that 22 of the 128 deceased patients had recognized diabetes and 27 had undiagnosed hyperglycemia. Medical evaluation and established guidelines for glycemia management had not been adhered to in either group, despite the presence of concomitant cardiovascular disease, they reported.

"This was true for assessment of long-term glycemic control or end organ damage, prescription of proper diet, and/or management of other cardiovascular complications," the researchers write.

"These findings indicate the need for more involvement by cardiologists in the care of patients with overt or latent diabetes beyond the steps taken against their established cardiovascular disease," they conclude. Cardiology 2002; 97: 183-186.