Taking diabetes to heart
Friday, 22 February 2019
Last year the International Diabetes Federation (IDF) conducted a groundbreaking survey. The global survey and following report was an initiative of the IDF with the support of Novo-Nordisk to gain an understanding of the knowledge of cardiovascular disease (CVD) among people living with type 2 diabetes (1).
- Data collection from September 2017 to May 2018
- Online questionnaire – 32 languages
- 12,695 participants
- 133 countries across all 7 IDF regions
- 17 questions
Cardiovascular disease in diabetes questionnaire subjects
- Risk knowledge
- Risk awareness
- Education by health professionals
- Information sources
The main findings of the survey were as follows:
- 1 in 10 did not know about CVD and its associated risk factors
- Over 9 in 10 had one or more CVD risk factors
- 1 in 4 participants considered themselves to be at no or low risk for CVD
- 1 in 5 people with T2D had experienced a CVD event, including heart attack, heart failure, brain haemorrhage, or stroke
- 1 in 4 participants with T2D had never discussed or could not remember having discussed their CVD risk with a health professional
- Only 1 in 4 had discussed their CVD risk with a health professional at the time of their T2D diagnosis
- 2 in 5 considered that T2D would not increase their CVD risk as long as they took medication
- 3 in 4 relied on CVD information from health professionals
- …yet 1 in 6 were unsatisfied or very unsatisfied with the information received from health professionals
- 2 in 3 felt they needed more information on the signs and symptoms of CVD
- 1 in 2 felt they needed more information about CVD risk factors
- 2 in 3 felt they needed more information on the self-management of diabetes
- 2 in 3 reported that they needed advice on how to reduce CVD through diet and exercise
Of people diagnosed with type 2 diabetes in Australia, only half will achieve treatment targets and half of those will achieve desired outcomes (2).
Causes of death of people living with diabetes as a percentage
The Australian institute of health and welfare reports diabetes is the underlying cause of death in only 28% of diabetes deaths. The other 72% of diabetes reported deaths were from were cancer, coronary heart disease and stroke associated with diabetes. (3)
What are the messages for us, as clinicians?
- Cardiovascular disease is the main cause of diabetes death and disability
- The link between diabetes and cardiovascular disease in people living with type 2 diabetes requires further clarity and support.
The questions we need to explore with people living with type 2 diabetes are:
- What is it about diabetes actually causes cardiovascular disease
- Why extra medications to manage blood pressure and cholesterol are prescribed
- Why following an annual cycle of care is important
- What our clients can do to directly improve their health and maintain quality of life.
As health professionals, we are time limited, often reducing the ability to have conversations. If you are finding yourself short of time, consider referring your clients to a DESMOND program. DESMOND is a one-day self-management education course for people living with type 2 diabetes. This state-wide program is funded by the National Diabetes Services Scheme to support your clients in between their visits with you.
For more information see our DESMOND events or contact us on 1300 136 588.
1. International Diabetes Federation. Taking diabetes to heart survey- Global survey on CVD awareness and knowledge among people with type 2 diabetes. Brussels, Belgium : s.n., 2018.
2. Sainsbury, E, et al. Burden of Diabetes in Australia: It’s time for more action, Preliminary report. s.l. : Diabetes Australia, 2018.
3. Australian Government: Australian Institute of Health and Welfare. Diabetes snapshot. s.l. : Australian Government: Australian Institute of Health and Welfare, 2018.
By Donna Itzstein, Diabetes Queensland Pharmacist