Diabetes Unit, Niguarda Cà Granda Hospital, Milan, Italy.
San Donato Hospital, Arezzo, Italy.
Diabetes Res Clin Pract. 2021 Dec;182:109131. doi: 10.1016/j.diabres.2021.109131. Epub 2021 Nov 8.
The European Society of Cardiology (ESC) recently defined cardiovascular risk classes for subjects with diabetes. Aim of this study was to explore the distribution of subjects with type 1 diabetes (T1D) by cardiovascular risk groups according to the ESC classification and to describe the quality indicators of care.
The study is based on data extracted from electronic medical records of patients treated at the 258 Italian diabetes centers participating in the AMD (Associazione Medici Diabetologi) Annals initiative. Patients with T1D were stratified by cardiovascular risk. Measures of intermediate outcomes, intensity/appropriateness of pharmacological treatment, and overall quality of care were evaluated.
Overall, 29.368 subjects with type 1 diabetes (64.7% at very high cardiovascular risk, 28.5% at high risk and 6.8% at moderate risk) were evaluated. A lack of use of drugs in case of high values and an inadequate control despite the antihypertensive and lipid-lowering treatment was recognized. The overall quality of care tended to be lower as the level of cardiovascular risk increased.
A large proportion of subjects with T1D is at high or very high risk. Antihypertensive and lipid-lowering treatment seem not adequately used. Several actions are necessary to improve the quality of care.
欧洲心脏病学会（ESC）最近为糖尿病患者定义了心血管风险类别。本研究旨在根据 ESC 分类探讨 1 型糖尿病（T1D）患者在心血管风险组中的分布，并描述护理质量指标。
该研究基于参与 AMD（Associazione Medici Diabetologi）年度计划的 258 家意大利糖尿病中心的电子病历中提取的数据。根据心血管风险对 T1D 患者进行分层。评估中间结果、药物治疗的强度/适当性以及整体护理质量的指标。
总体而言，评估了 29368 名 1 型糖尿病患者（64.7%为极高心血管风险，28.5%为高风险，6.8%为中风险）。发现存在血压值升高但未使用药物和降压降脂治疗后控制不佳的情况。随着心血管风险水平的升高，整体护理质量有下降趋势。
很大一部分 T1D 患者处于高或极高风险。降压和降脂治疗的应用似乎并不充分。需要采取多项措施来提高护理质量。
