Physician attitudes and practices and patient awareness of the cardiovascular complications of diabetes

Abstract

Objectives: Studies were conducted to: 1) assess physicians’ attitudes and practices in managing cardiovascular disease (CVD) risks in diabetes; and 2) determine the awareness of CVD risks among diabetic patients. Background: Cardiovascular disease is the leading cause of premature death among diabetic patients. As diabetes is often seen as a “glucose-centric” disease, it is unclear whether diabetic patients are talking with their doctors about CVD and other key clinical parameters of diabetes care such as blood pressure and cholesterol. Methods: An online survey was completed by a nationally representative sample of 900 physicians. The 95% confidence interval is approximately ±2.5%. Before this study, a telephone survey of 2,008 people with diabetes was conducted using random, direct-dial screenings of U.S. households. Results: Ninety-one percent of physicians believe that their patients with diabetes are “very” or “extremely” likely to have a cardiovascular event. Although physicians report discussing CVD risk factors with 88% of their diabetic patients, they perceive their diabetic patients as being only moderately knowledgeable about their increased CVD risks. Sixty-eight percent of the people with diabetes do not consider CVD to be a serious complication of diabetes; they are more likely to be aware of complications such as blindness (65%) or amputation (36%) rather than heart disease (17%), heart attack (14%), or stroke (5%). Physicians perceive “poor compliance” with behavioral modifications and medication regimens as the greatest barriers to the management of CVD risks in diabetic patients. Conclusions: Materials should be made available to help facilitate communication about CVD risks, and strategies for improving compliance with life-style modifications and multiple drug therapies should be explored. Efforts should continue to promote a comprehensive approach to the management of diabetes to include aggressive control of blood glucose and other CVD risk factors.