scholarly journals Practice and patient characteristics related to blood pressure in patients with type 2 diabetes in primary care: a cross-sectional study

2007 ◽  
Vol 24 (6) ◽  
pp. 547-554 ◽  
Author(s):  
C. Bebb ◽  
C. Coupland ◽  
J. Stewart ◽  
D. Kendrick ◽  
R. Madeley ◽  
...  
2017 ◽  
Vol 30 (3) ◽  
pp. 197 ◽  
Author(s):  
Inês Rosendo ◽  
Luiz Miguel Santiago ◽  
Margarida Marques

Introduction: Determine whether socio-demographic, habits and risk factors are associated with a better tensional control in type 2 diabetes in primary care patients in order to identify a specific target population for compensatory interventions improving diabetes control and reducing its morbi-mortality.Material and Methods: Cross-sectional study in primary care. Randomized type 2 diabetes patient data collection by their volunteer family doctors, proportionally stratified from the 5 Portuguese continental regions. Variables: blood pressure, age, gender, education, diabetes duration, HbA1c, smoking habits, weight, waist circumference, physical activity and adherence to medication. Bivariate and logistic regression analysis to evaluate each measured variable’s independent association with uncontrolled blood pressure (≥ 140/90).Results: 709 patients were included in the study, 60.2% men, mean age 66.12 ± 10.47 years. In logistic regression analysis, the factors independently associated to uncontrolled BP were lower education (p = 0.014), shorter diabetes duration (p = 0.002), higher waist circumference (p < 0.001), higher pulse pressure (p < 0.001), higher physical activity level (p = 0.043) and being a smoker (p < 0.001).Discussion: The main limitations are the fact that the sample was not totaly random and included only primary care patients, a possible inter-observer bias and being a cross-sectional study, thus not providing information on temporal relation or causality.Conclusion: The sub-group of people with diabetes identified to have worse tensional control should have a different and more intensive approach in primary care. We recommend further longitudinal and population based confirmatory research.


BJGP Open ◽  
2019 ◽  
Vol 3 (1) ◽  
pp. bjgpopen18X101636 ◽  
Author(s):  
Bjørn Gjelsvik ◽  
Anh Thi Tran ◽  
Tore J Berg ◽  
Åsne Bakke ◽  
Ibrahimu Mdala ◽  
...  

BackgroundCoronary heart disease (CHD) and stroke are the major causes of death among people with diabetes.AimTo describe the prevalence and onset of CHD and stroke among patients with type 2 diabetes mellitus (T2DM) in primary care in Norway, and explore the quality of secondary prevention.Design & settingA cross-sectional study of data was undertaken from electronic medical records (EMRs) of 10 255 patients with T2DM in general practice. The study took place in five counties of Norway (Oslo, Akershus, Rogaland, Hordaland, and Nordland). Quality of care was assessed based on national guideline recommendations.MethodSummary statistics with adjustments and binary logistic regression models were used.ResultsIn total, 2260 patients (22.1%) had CHD and 759 (7.4%) had stroke. South Asians had significantly more CHD than ethnic Norwegians (29.5%, 95% confidence interval [CI] = 26.1 to 33.0 versus 21.5%, CI = 20.6 to 22.3) and other ethnic groups, and experienced onset of CHD or stroke at a mean of 7 years before Norwegians. In 47.9% of the patients, CHD was diagnosed before T2DM. Treatment target for low-density lipoprotein (LDL) cholesterol was reached for 30.0% and for systolic blood pressure (SBP) for 65.1% of the patients with CHD. Further, 20.9% of patients with CHD were present smokers, and only 5.0% of patients reached all four treatment targets (no smoking, HbA1c ≤7.0%, SBP <135 mmHg, LDL-cholesterol <1.8 mmol/l).ConclusionThe diagnosis of CHD preceded the diagnosis of T2DM in half of the patients. The prevalence of CHD was highest and onset earlier among ethnic South Asians. More intensive treatment of lipids, blood pressure, and smoking are needed in patients with T2DM and CHD.


BMJ Open ◽  
2018 ◽  
Vol 8 (12) ◽  
pp. e025125 ◽  
Author(s):  
Iliza Idris ◽  
Hizlinda Tohid ◽  
Noor Azimah Muhammad ◽  
Mohd Radzniwan A Rashid ◽  
Azainorsuzila Mohd Ahad ◽  
...  

ObjectivesThis study aimed to determine the prevalence of anaemia among patients with type 2 diabetes mellitus (T2DM) and chronic kidney disease (CKD) at primary care settings and its associated factors.Design, setting and participantsThis cross-sectional study involved 808 adult patients with T2DM and CKD who were recruited via systematic sampling from 20 public primary care clinics in Peninsular Malaysia. Their sociodemographic, clinical and biomedical profiles were collected through interviews, examination of medical records and blood testing.ResultsThe prevalence of anaemia was 31.7% (256/808). The anaemia was mainly mild (61.5%) and normocytic normochromic (58.7%). About 88.7% of the patients with anaemia were not known to have anaemia prior to the study. Among 36 patients with documented history of anaemia, 80.6% were still anaemic, and only a half received iron therapy. Multivariate regression analysis showed that women (adjusted odd ratio (AOR): 1.57, 95% CI: 1.12 to 2.21, p=0.009) and those with older age (AOR: 1.04, 95% CI: 1.01 to 1.06, p<0.001), CKD stage 3a (AOR: 2.47; 95% CI: 1.25 to 4.87, p=0.009), CKD stage 3b (AOR: 4.36; 95% CI: 2.14 to 8.85, p<0.001), CKD stage 4 (AOR: 10.12; 95% CI: 4.36 to 23.47, p<0.001), CKD stage 5 (AOR: 10.80; 95% CI: 3.32 to 35.11, p<0.001) and foot complication (AOR 3.12, 95% CI: 1.51 to 6.46, p=0.002) were more likely to have anaemia. Having higher body mass index (AOR 0.95, 95% CI: 0.92 to 0.99, p=0.012) and higher diastolic blood pressure (AOR 0.97, 95% CI: 0.95 to 0.99, p<0.001) were associated with lower odds to have anaemia.ConclusionAnaemia among patients with T2DM and CKD in primary care was common, and the majority was unrecognised. Inadequate treatment of anaemia was also prevalent. Therefore, screening of anaemia should be incorporated into the routine assessment of diabetic complications particularly for those with significant associated factors. It is hoped that such strategy could lead to early treatment and hence improve their overall care.Trial registration numberNMRR-15-660-24324.


PeerJ ◽  
2016 ◽  
Vol 4 ◽  
pp. e2577 ◽  
Author(s):  
Irma Elizabeth Huayanay-Espinoza ◽  
Felix Guerra-Castañon ◽  
María Lazo-Porras ◽  
Ana Castaneda-Guarderas ◽  
Nimmy Josephine Thomas ◽  
...  

ObjectiveThe objective of this study was to assess patients’ achievement of ADA (American Diabetes Association) guideline recommendations for glycosylated hemoglobin, lipid profile, and blood pressure in a type 2 diabetes mellitus (T2DM) outpatient clinic in a low-middle income country (LMIC) setting.MethodsThis is a descriptive cross-sectional study with 123 ambulatory T2DM patients who are being treated at a public hospital in Lima, Peru. Data was gathered via standardized interviews, clinical surveys, and anthropomorphic measurements for each patient. Blood samples were drawn in fasting state for measures of glucose, glycosylated hemoglobin (HbA1c), and lipid profile. Laboratory parameters and blood pressure were evaluated according to ADA recommendations.ResultsOf the 123 patients, 81 were women and the mean age was 61.8 years. Glycemic control was abnormal in 82 (68.33%) participants, and 45 (37.50%) were unable to control their blood pressure. Lipid profile was abnormal in 73 (60.83%) participants. Only nine (7.50%) participants fulfilled ADA recommendations for glycemic, blood pressure, and lipid control.ConclusionsAmongst individuals with type 2 diabetes, there was poor attainment of the ADA recommendations (HbA1c, blood pressure and LDL-cholesterol) for ambulatory T2DM patients. Interventions are urgently needed in order to prevent long-term diabetic complications.


BMJ Open ◽  
2019 ◽  
Vol 9 (10) ◽  
pp. e031281 ◽  
Author(s):  
Manel Mata-Cases ◽  
Josep Franch-Nadal ◽  
Jordi Real ◽  
Marta Cedenilla ◽  
Didac Mauricio

ObjectivesTo evaluate the prevalence and coprevalence of several chronic conditions in patients with type 2 diabetes in a Mediterranean region.DesignA cross-sectional study.SettingTwo hundred and eighty-six primary care teams of the Catalonian Health Institute (Catalonia, Spain).ParticipantsWe included patients aged ≥18 years with a diagnosis of type 2 diabetes by 31 December, 2016, who were registered in the Information System for the Development of Research in primary care (SIDIAP) database. We excluded patients with a diagnosis of type 1 diabetes, gestational diabetes mellitus and any other type of diabetes.Primary and secondary outcome measuresWe collected data on diabetes-related comorbidities (ie, chronic complications, associated cardiovascular risk factors and treatment complications). Diagnoses were based on the International Classification of Diseases, 10thRevision codes recorded in the database or, for some entities, on the cut-off points for a particular test result or a specific treatment indicated for that entity. The presence and stage of chronic kidney disease (CKD) were based on the glomerular filtration rate, the CKD Epidemiology Collaboration creatinine equation and the urine albumin-to-creatinine ratio.ResultsA total of 373 185 patients were analysed. 82% of patients exhibited ≥2 comorbidities and 31% exhibited ≥4 comorbidities. The most frequent comorbidities were hypertension (72%), hyperlipidaemia (60%), obesity (45%), CKD (33%), chronic renal failure (CRF)(28%) and cardiovascular disease (23%). The most frequently coprevalent pairs of chronic conditions were the combination of hypertension with hyperlipidaemia (45%), obesity (35%), CKD (28%), CRF (25%) or cardiovascular disease (19%), as well as the combination of hyperlipidaemia with obesity (28%), CKD (21%), CRF (18%) or cardiovascular disease (15%); other common pairs of comorbidities were obesity/CKD, obesity/CRF, hypertension/retinopathy, hypertension/albuminuria, hypertension/urinary tract infection, CVD/CRF and CVD/CKD, which were each present in more than 10% of patients.ConclusionPatients with type 2 diabetes have a high frequency of coprevalence of metabolic risk factors, cardiovascular disease and CKD and thus require an integrated management approach.


2017 ◽  
Vol 2017 ◽  
pp. 1-8 ◽  
Author(s):  
Alessandra Teixeira Neto Zucatti ◽  
Tatiana Pedroso de Paula ◽  
Luciana Verçoza Viana ◽  
Rafael DallAgnol ◽  
Felipe Vogt Cureau ◽  
...  

The aim of this study is to evaluate the association between usual physical activity and 24 h blood pressure (BP) profile in people with type 2 diabetes mellitus (DM). This is a cross-sectional study of 151 participants with type 2 DM. Usual physical activity was assessed by step counting and self-reported questionnaire. BP was measured in office and by 24 h ambulatory BP monitoring (ABPM; 24 h, daytime and nighttime). Mean participant age was 61.1 ± 8.4 years, 64% was women, and mean duration of diabetes was 14.3 ± 8.5 years. Ninety-two percent of participants had hypertension, and office BP was 138 ± 18/78 ± 10 mmHg. Inverse correlations were observed between step count and 24 h BP (systolic, r=−0.186; p=0.022), daytime BP (systolic, r=−0.198; p=0.015), and nighttime BP (pulse pressure, r=−0.190; p=0.019). People were categorized into tertiles of daily step count, and the 1st tertile had higher 24 h systolic BP, daytime systolic BP, daytime mean BP, and daytime systolic BP load than those in the other tertiles, even after adjusting for age and HbA1c. Participants with type 2 DM and low levels of physical activity exhibit higher 24 h and daytime systolic ambulatory BP values as compared with those who performed more steps per day, even after adjustments for confounding factors.


Sign in / Sign up

Export Citation Format

Share Document