Five-year follow-up of cardiovascular risk factors in people with newly diagnosed Type II diabetes

In 1991 we performed a retrospective survey of the management of 130 newly diagnosed Type II diabetic patients. After 1 year only blood glucose control had improved. We now present a review of the management and outcome of the same patients (mean age 63 (range 31-88) years at presentation and BMI 29.8 (21.4-44.9) kg/m2), after more than 5 years follow-up. Comparing referral and 5-year results, patients alive and not insulin-treated had a reduction in HbA1 of 2.2 (95% CI: -2.8 to -1.6)%, but no change in BMI [-0.2 (-0.6 to 0.3)] kg/m2. There was a statistically significant reduction in serum cholesterol of 0.4 (-0.7 to -0.1) mmol/l and a reduction in the proportion of patients with serum cholesterol > 6.5 mmol/l (35 to 16%, p <0.01), but the proportion of patients with a serum cholesterol > 5.2 mmol/l remained high (73 compared with 71%). There was no change in non-fasting triglycerides [-0.2 (-0.5 to 0.1) mmol/l]. Only 12 (12%) patients had been prescribed lipid lowering medication. The prevalence of smoking in living patients fell from 27 to 16%. Blood pressure showed little change [1/-3 (-5 to 6/-7 to 0) mmHg] and the proportion of patients with a blood pressure > 160/95 remained high (38% at referral and 5 years). Our results suggest that a more aggressive approach is needed in the management of cardiovascular risk factors in Type II diabetes.