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

• Published in: BMC cardiovascular disorders Vol. 16; no. 1; p. 220
• Main Authors: Jeong, In-Kyung, Kim, Sin-Gon, Cho, Dong Hyeok, Kim, Chong Hwa, Kim, Chul Sik, Lee, Won-Young, Won, Kyu-Chang, Kim, Doo-Man
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 14.11.2016; BioMed Central
• Subjects: Adult; Analysis; Atherosclerosis; Atherosclerosis - diagnosis; Atherosclerosis - epidemiology; Atherosclerosis - etiology; Behavior; Cardiovascular diseases; Care and treatment; Carotid Arteries - diagnostic imaging; Carotid Arteries - physiopathology; Carotid Artery Diseases - diagnosis; Carotid Artery Diseases - epidemiology; Carotid Artery Diseases - etiology; Carotid Intima-Media Thickness; Complications and side effects; Diabetes Mellitus, Type 2 - complications; Diabetes Mellitus, Type 2 - diagnosis; Female; Follow-Up Studies; Humans; Male; Middle Aged; Patients - psychology; Physician and patient; Physicians - psychology; Prospective Studies; Risk Assessment - methods; Risk Factors; Time Factors; Type 2 diabetes; United Kingdom - epidemiology; United Kingdom; Type 2; Cardiovascular disease; Behavior; Carotid atherosclerosis; Diabetes mellitus
• ISSN: 1471-2261; 1471-2261
• DOI: 10.1186/s12872-016-0401-5

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. 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. 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. 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.