Key result
Fewer than ~25% of diabetes outpatients achieve guideline-recommended HbA1c targets despite meeting other CV goals.
Why the study?
Adequate cardiovascular risk control prevents complications and guidelines recommend a multifactorial management approach, prompting evaluation of real-world risk factor target attainment and medication prescriptions among diabetes outpatients.
Cohort (n=81,096)
Yes
Answers are grounded in this paper and cite their sources.
In a nationwide Dutch cohort of 81,096 secondary/tertiary care diabetes outpatients, most cardiovascular risk factor targets were met by at least two-thirds of patients, but strict glycemic control (HbA1c ≤7.0%) and secondary-prevention LDL-C targets (<1.8 mmol/L) remained achieved by only about one-quarter to one-third of adults.
AIMS: Adequate cardiovascular risk control prevents complications. A multifactorial approach for simultaneously managing risk factors is recommended by guidelines. We evaluated cardiovascular risk factors among Dutch diabetes outpatients and described glucose-lowering and cardiovascular prescriptions. METHODS: From the Dutch Pediatric and Adult Registry of Diabetes (DPARD), a cohort of 81,096 patients with type 1 diabetes (T1D) or type 2 diabetes (T2D) was derived from 2017 to 2024. Descriptive statistics reported patient characteristics and the primary outcomes cardiovascular risk targets and medication prescription patterns. RESULTS: Overall, 3,832 children had T1D, 145 children had T2D, 35,934 adults had T1D and 41,185 adults had T2D. For most cardiovascular risk factors, guideline-recommended targets were met by at least two-thirds of patients, whereas some risk factors had lower attainment in specific subgroups. HbA1c was the least frequently reached target. The most common medications for T1D were fast-acting and long-acting insulins. For T2D, these were biguanides, insulins, sulfonylureas, GLP-1 agonists, and SGLT2 inhibitors. CONCLUSIONS: This study shows the extent to which guideline-recommended cardiovascular risk factor targets are met in children and adults with T1D and T2D, which varies by age group and diabetes type. These findings may refine individually tailored strategies for management of risk factors, particularly HbA1c.
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Lit et al. (2026) conducted a cohort in Type 1 or type 2 diabetes mellitus (n=81,096). Real-world outpatient diabetes and cardiovascular risk management was evaluated on Attainment of guideline-recommended modifiable cardiovascular risk factor targets (HbA1c, BMI, blood pressure, LDL-cholesterol, eGFR) and medication prescription patterns. Dutch diabetes outpatients met most cardiovascular risk targets in ≥50% of cases, but HbA1c ≤7.0% was achieved by only 27% of T1D adults, 22% of T1D children, and 23% of T2D adults.
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