Risk factors

Risk factor management cuts cardiovascular admissions for Australians with diabetes

Aggressive management of cardiometabolic risk factors is being credited for a substantial decline in cardiovascular-related hospital admissions in Victorians with diabetes in recent years.

Rates of acute myocardial infarction, stroke and heart failure-related admissions to hospitals declined more rapidly for people with type 1 and type 2 diabetes than for those without diabetes, between 2004 and 2016, according to research published in the MJA.

Researchers from St Vincent’s Hospital, Melbourne University and La Trobe University based their findings on hospital discharge data for the three cardiovascular disease complications in 382,107 patients up to 2016. The figures included 278, 991 admissions for people without diabetes (73%), 3645 with type 1 diabetes (1%), and 99, 471 with type 2 diabetes.

They found that acute MI admission rates declined during this period for people with type 2 diabetes (–11.4% per year) and type 1 diabetes (–7.7% per year) as well as for people without diabetes (–5.0% per year). People with T1d showed a higher decline (–15.1%) in the period for 2009–2016.

Stroke admission rates declined significantly during the 2004–2016 period for people with type 1 diabetes (–7.2% per year); while for people with type 2 diabetes, rates showed an overall change of –11.9% per year.

For patients without diabetes, the decline in stroke-related admissions was significant for 2005–2014 (–4.1% per year), but not during 2015–2016.

Admissions for heart failure declined during 2004–2016 for people with type 1 diabetes (–10.3% per year) or type 2 diabetes (–9.2% per year), and also modestly for people without diabetes (-2.8%)”

The researchers concluded that the relatively greater absolute decline in the number of admissions for people with diabetes “may be related to the fact that they are considered to be at high risk for cardiovascular disease and are therefore treated more aggressively”.

“The scope for reducing risk with multifactorial target-driven interventions is greater in these patients,” they wrote.

“Nevertheless, admission rates for cardiovascular complications of people with diabetes remain relatively high.”

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