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Modifiable cardiovascular risk factors in adults with diabetes: prevalence and missed opportunities for physician counseling. Arch Intern Med 2002 Feb 25;162(4):427-33 PMID: 11863475

Pubmed ID

11863475

Abstract

BACKGROUND: Cardiovascular disease (CVD) is the leading cause of death in adults with diabetes mellitus (DM). Counseling by physicians is effective in inducing lifestyle modification.

OBJECTIVE: To determine the prevalence of modifiable CVD risk factors and counseling by physicians among adults with DM.

METHODS: Data on 9496 adults with DM and 150 493 adults without DM from the 1999 Behavioral Risk Factor Surveillance System were analyzed to yield estimates of CVD risk factors and counseling by physicians during routine visits. Multiple logistic regression was used to adjust estimates for age, sex, ethnicity, education, and income. Population estimates were created using software for the statistical analysis of correlated data (SUDAAN) because of the complex survey design of the Behavioral Risk Factor Surveillance System.

RESULTS: Diabetes mellitus was more prevalent in adults aged 55 and older and in blacks and Hispanic or other ethnicities (both P<.001). Modifiable CVD risk factors, such as hypertension (56% vs 22%), high cholesterol (41% vs 20%), obesity (78% vs 57%), and insufficient physical activity (66% vs 56%), were more prevalent in adults with DM (all P<.001) and differed by ethnicity, sex, and age. Counseling about weight loss (50% vs 21%, P<.001), smoking cessation (78% vs 67%, P =.01), eating less fat (78% vs 71%, P<.001), and increasing physical activity (67% vs 36%, P<.001) was less than ideal in both groups and did not change after adjusting for age, sex, ethnicity, education, and income with multiple logistic regression.

CONCLUSIONS: Although adults with DM have a high prevalence of modifiable CVD risk factors, counseling by physicians about lifestyle modification is less than optimal. There is a need to improve patient counseling for lifestyle modification by primary care physicians.

Author List

Egede LE, Zheng D

Author

Leonard E. Egede MD Center Director, Chief, Professor in the Medicine department at Medical College of Wisconsin




MESH terms used to index this publication - Major topics in bold

Adult
Age Factors
Aged
Cardiovascular Diseases
Counseling
Cross-Sectional Studies
Diabetes Complications
Diabetes Mellitus
Educational Status
Female
Humans
Income
Life Style
Male
Middle Aged
Physicians, Family
Regression Analysis
Risk Factors
jenkins-FCD Prod-353 9ccd8489072cb19f5b9f808bb23ed672c582f41e