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Rationale:
- Treatment of concomitant risk decreases the risk of coronary events.
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Evidence:
- Within 8 years after diagnosis, as many as 45% of patients experience macrovascular complications of diabetes (171).
- Cardiovascular complications—the most common advanced complications associated with type 2 diabetes—account for 50% to 60%
of all diabetes-related mortality (172; 173).
- Modification of macrovascular risk factors can reduce risk of disease. Aggressive hypertension control, in particular, has
been shown to reduce macrovascular event rates (26).
- Patients with diabetes have mortality rates almost twice that of the general population (174; 175; 176).
- Younger patients, in particular, have high excess mortality; the incremental mortality risk seems to decrease with older age
of onset (25; 177).
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Comments:
- Although educational interventions have been proven effective as a whole, individualized components (e.g., explaining the
incidence of macrovascular disease) have not been well evaluated.
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Sandeep Vijan, MD has no financial relationships with pharmaceutical companies, biomedical device manufacturers, or health-care related organizations.
Darren B. Taichman, MD, PhD, Editor, PIER, has received grant support from Actelion Pharmaceuticals Ltd , and honoraria for
continuing medical education grand rounds and lectures given.
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The information included herein should never be used as a substitute
for clinical judgment and does not represent an official position of
ACP. Because all PIER modules are updated regularly, printed web pages
or PDFs may rapidly become obsolete. Therefore, PIER users should
compare the date of the last update on the website with any printout
to ensure that the information being referred to is the most current
available.
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PIER is copyrighted (c) 2010 by the American College of Physicians,
190 N. Independence Mall West, Philadelphia, PA 19106-1572, USA.
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Diabetes Mellitus, Type 2
> Patient Education
