An Integrative Literature Review of Cardiac Risk Factor Management in Diabetes Education Interventions

2000 ◽  
Vol 26 (5) ◽  
pp. 812-820 ◽  
Author(s):  
Kimberly O. Lacey ◽  
Deborah A. Chyun ◽  
Margaret Grey
Keyword(s):  
Type 2 Diabetes ◽  
Risk Factor ◽  
Literature Review ◽  
Diabetes Management ◽  
Diabetes Education ◽  
Cardiac Risk ◽  
Cardiac Risk Factor ◽  
Risk Factor Management ◽  
Education Interventions

PURPOSE the purposes of this paper are to (1) review the literature on educational interventions for adults with type 2 diabetes; (2) determine what kinds of interventions have been studied; (3) identify which interventions have included cardiac risk factor management; (4) determine how effective these interventions have been on metabolic control, diabetes-related outcomes, and cardiovascular-related outcomes; and (5) make recommendations for further research on combined interventions designed to promote optimal diabetes and cardiac risk factor management in adults with type 2 diabetes. METHODS Using an integrative literature review approach, 64 studies on diabetes education interventions for adults with diabetes published between 1987 and 1998 were reviewed; 44 met these criteria. RESULTS Few studies included cardiac risk factor management, which should be an integral part of diabetes management. Most studies demonstrated a beneficial effect of education on the management of type 2 diabetes but not cardiovascular risk. CONCLUSIONS Identifying strategies that promote effective disease management for improved diabetes control and reduction of cardiac events in adults with diabetes is essential. Further intervention studies focusing on the combined management of diabetes and cardiac risk factors are warranted.

Glucose and Cardiac Risk Factor Control in Individuals With Type 2 Diabetes

2006 ◽  
Vol 32 (6) ◽  
pp. 925-939 ◽  
Author(s):  
Deborah Chyun ◽  
Kimberly O. Lacey ◽  
Deborah M. Katten ◽  
Sandra Talley ◽  
Wendie J. Price ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Risk Factor ◽  
Cardiac Risk ◽  
Cardiac Risk Factor ◽  
Risk Factor Control

Cardiac risk factor management

1991 ◽  
Vol 155 (11-12) ◽  
pp. 851-851
Author(s):  
Graham J Macdonald ◽  
Leah Bernstein
Keyword(s):  
Risk Factor ◽  
Cardiac Risk ◽  
Cardiac Risk Factor ◽  
Risk Factor Management

scholarly journals Blood pressure variability and risk of heart failure in ACCORD and the VADT

2020 ◽  
Author(s):  
Daniel S. Nuyujukian ◽  
Juraj Koska ◽  
Gideon Bahn ◽  
Peter D. Reaven ◽  
Jin J. Zhou ◽  
...  
Keyword(s):  
Heart Failure ◽  
Blood Pressure ◽  
Type 2 Diabetes ◽  
Risk Factor ◽  
Blood Pressure Variability ◽  
Treatment Strategies ◽  
Risk Factor Management ◽  
Increased Risk ◽  
Blood Pressure Treatment

Objective: Although blood pressure variability is increasingly appreciated as a risk factor for cardiovascular disease, its relationship with heart failure is less clear. We examined the relationship between blood pressure variability and risk of heart failure (HF) in two cohorts of type 2 diabetes participating in trials of glucose and/or other risk factor management. <p> </p> <p>Research Design and Methods: Data were drawn from the Action to Control Cardiovascular Risk in Diabetes (ACCORD) trial and the Veterans Affairs Diabetes Trial (VADT). Coefficient of variation (CV) and average real variability (ARV) were calculated for systolic (SBP) and diastolic blood pressure (DBP) along with maximum and cumulative mean SBP and DBP during both trials. </p> <p> </p> <p>Results: In ACCORD, CV and ARV of SBP and DBP were associated with increased risk of HF, even after adjusting for other risk factors and mean blood pressure (e.g., CV-SBP: HR=1.15, <i>p</i> = 0.01; CV-DBP: HR=1.18, <i>p</i> = 0.003). In the VADT, DBP variability was associated with increased risk of HF (ARV-DBP: HR=1.16, <i>p</i> = 0.001; CV-DBP: HR=1.09, <i>p</i> = 0.04). Further, in ACCORD, those with progressively lower baseline blood pressure demonstrated a stepwise increase in risk of HF with higher CV-SBP, ARV-SBP, and CV-DBP. Effects of blood pressure variability were related to dips, not elevations, in blood pressure.</p> <p> </p> <p>Conclusions: Blood pressure variability is associated with HF risk in individuals with type 2 diabetes, possibly a consequence of periods of ischemia during diastole. These results may have implications for optimizing blood pressure treatment strategies in those with type 2 diabetes.</p>

scholarly journals Intensive Risk Factor Management and Cardiovascular Autonomic Neuropathy in Type 2 Diabetes: The ACCORD Trial

Diabetes Care ◽  
2020 ◽  
Vol 44 (1) ◽  
pp. 164-173
Author(s):  
Yaling Tang ◽  
Hetal Shah ◽  
Carlos Roberto Bueno Junior ◽  
Xiuqin Sun ◽  
Joanna Mitri ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Risk Factor ◽  
Autonomic Neuropathy ◽  
Cardiovascular Autonomic Neuropathy ◽  
Risk Factor Management

Abstract P73: Social Support and Adherence to Cardiac Risk Factor Management Instructions during the First Year after Acute Myocardial Infarction

2011 ◽  
Vol 4 (suppl_1) ◽  
Author(s):  
Erica C Leifheit-Limson ◽  
Kimberly J Reid ◽  
Stanislav V Kasl ◽  
Haiqun Lin ◽  
Philip G Jones ◽  
...  
Keyword(s):  
Social Support ◽  
Risk Factor ◽  
Repeated Measures ◽  
Diabetes Management ◽  
A Priori ◽  
Clinical History ◽  
Poor Adherence ◽  
Cardiac Risk Factor ◽  
First Year ◽  
Risk Factor Management

Background: Adherence to risk factor management (RFM) instructions after AMI can promote recovery. The prognostic importance of social support for adherence is not well understood. We examined the relationship between baseline social support and post-AMI RFM adherence, and tested whether depression moderates this association. Methods: Using data from 2202 AMI patients enrolled in the 19-site PREMIER study, we longitudinally examined whether low baseline social support (index hospitalization; score <=18 on 5 items from ENRICHD Social Support Inventory) is associated with poor adherence to 13 RFM instructions (medication adherence, warfarin use, follow-up plan/appointments, whom to call, cholesterol monitoring and therapy, diabetes management, weight monitoring and loss, smoking cessation, diet, exercise, cardiac rehabilitation) within the first year of recovery. Patients were asked at 1, 6, and 12 months if they received any of the RFM instructions since their last interview. Poor adherence was defined a priori as adhering “very carefully” to less than 50% of the patient-appropriate instructions. Hierarchical repeated-measures Poisson regression evaluated the association between support and adherence, with adjustment for site, sociodemographics, clinical history and presentation, hospital and outpatient care, and depression. Whether depression (PHQ-9 score >=10) modified the association was evaluated by stratifying the risk-adjusted model by depression status and including a support*depression interaction term. Results: Patients with low social support had greater unadjusted risk of poor adherence than patients with high social support (RR 1.46, 95% CI 1.27-1.67). This association did not vary with time and remained significant after full risk adjustment (RR 1.24, 95% CI 1.05-1.47). In depression-stratified analyses, the risk-adjusted association of low support with poor adherence was significant among nondepressed (RR 1.44, 95% CI 1.26-1.66) but not depressed (RR 1.03, 95% CI 0.79-1.33) patients (p<0.001 for support*depression interaction). Conclusion: Good social support may improve adherence among nondepressed AMI patients, but more research is needed to understand the role of social support among depressed patients.

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