Impact of carotid atherosclerosis detection on physician and patient behavior in the management of type 2 diabetes mellitus: a prospective, observational, multicenter study.

In-Kyung Jeong; Sin-Gon Kim; Dong Hyeok Cho; Chong Hwa Kim; Chul Sik Kim; Won-Young Lee; Kyu-Chang Won; Doo-Man Kim

Background: This study compared carotid ultrasound (CUS) and traditional risk calculations in determining cardiovascular disease (CVD) risk in patients with type 2 diabetes mellitus (DM) and investigated whether awareness of CVD affects patient and/or physician behavior. Methods: In this prospective, observational, multicenter study, 797 participants with type 2 diabetes were assessed using CUS, the United Kingdom Prospective Diabetes Study Risk Engine (UKPDSRE) calculator, and the Framingham Risk Score (FRS) algorithm. Health-related behaviors and physician treatments were compared at baseline and at 6 months after assessment. Results: According to CUS, 43.5 % of the participants were at high risk (compared to 10.6 % and 4.3 % using the UKPDSRE and FRS approaches, respectively). Interestingly, 31.5 % of the patients with low risk scores according to the UKPDSRE calculator and 35.8 % of the patients with low risk scores according to the FRS algorithm were found to be at high risk according to CUS. The proportion of patients who achieved target LDL-C levels significantly increased after CUS. Moreover, increased awareness of atherosclerosis through CUS findings significantly altered physician treatment patterns and patient health-related behaviors. Conclusions: Carotid atherosclerosis was detected in more than 30 % of all participants with low or intermediate risk stratification scores. Improved awareness of atherosclerosis through CUS findings had a positive impact on both patient and physician behavior, resulting in improved CV risk management.

ATHEROSCLEROSIS; TYPE 2 diabetes treatment; PATIENTS' attitudes; PHYSICIANS' attitudes; CARDIOVASCULAR diseases risk factors; CAROTID artery diseases

BMC Cardiovascular Disorders, 2016, Vol 16, p1

1471-2261

Academic Journal

10.1186/s12872-016-0401-5