Control of Major Cardiovascular Risk Factors in Patients with Type 2 Diabetes and Diabetic Foot Syndrome

Abstract

Cardiovascular disease (CVD) is the main cause of death in patients with diabetes mellitus (DM). Cardiovascular risk in patients with type 2 diabetes is 2–4 times higher, and CVD occurs 15 years earlier than in people without diabetes. Timely detection and effective control of risk factors are of decisive importance for the prevention of complications of type 2 diabetes. The aim of the study: to identify cardiovascular risk factors and analyze the effectiveness of their control in patients with type 2 DM and diabetic foot syndrome (DFS). Material and methods. 80 patients with type 2 diabetes without associated CVD. Mean age 64.6 ± 9.2 years. The duration of type 2 diabetes was 10.0 (4.0; 15.0) years. Conducted a clinical examination, laboratory (clinical and biochemical blood tests) and instrumental (electrocardiography, ultrasound of the brachiocephalic arteries and arteries of the lower extremities, echocardiography, volumetric sphygmography) studies. Results. The frequency of detection of hypertension was 98.8%, dyslipidemia 91.0%. Target values of blood pressure (BP) were noted in 32.0%, and target values of low-density lipoprotein cholesterol (LDL-C) in 26.0% of the examined. 80.0% of patients received antihypertensive therapy, and 39.7% of patients received lipid-lowering therapy. Metformin was the most commonly prescribed oral hypoglycemic drug in the structure of drug therapy for type 2 diabetes. Insulin was significantly more frequently prescribed to patients with DFS. The target level of glycated hemoglobin (HbA1c) was observed in 55.0% of patients. Patients with DFS had significantly higher systolic and pulse BP, and reached the target BP values three times less often. Conclusion. Patients with type 2 diabetes are characterized by insufficiently effective control of glycemia and major cardiovascular risk factors. Thus, the target HbA1c levels were noted in every second patient, the target BP level in every third patient, and the target values of LDL-C only in every fourth patient.