The management of cardiovascular risk in people with diabetes: Insights from an audit of health services providing diabetes care

Abstract

Aims

To assess cardiovascular risk management among Australians with diabetes.

Methods

Retrospective analysis of clinical audit data collected from diabetes centres participating in the Australian National Diabetes Audit in 2022. Adults (≥18 years) with type 1 or type 2 were included. Clinical performance was assessed by comparing modifiable cardiovascular risk factors against evidence-based clinical targets at the national and diabetes centre level for the total cohort, with sub-analyses by diabetes type, and by cardiovascular disease (CVD) status.

Results

There were 4341 people included; 32.4 % with type 1 and 67.6 % with type 2 diabetes. Of the total cohort, 25.9 % met the HbA1c target (≤7% or 53 mmol/mol), 45.5 % met the low-density lipoprotein cholesterol target (<2 mmol/L), 43.4 % met the systolic blood pressure target (<130 mmHg), 19.8 % met the body mass index target (<25 kg/m²), 30.2 % met the physical activity target (≥150 mins/week of moderate-to-vigorous intensity), and 85.0 % were non-smokers. Compared to patients with type 1 diabetes, patients with type 2 diabetes were less likely to meet targets. Compared to patients without existing CVD, patients with CVD were less likely to meet targets.

Conclusions

Management of cardiovascular risk in adults with diabetes is sub-optimal, increasing the risk of preventable adverse health outcomes.