Recognising and Treating the Diabetic Patient in Cardiovascular Care

Abstract

The global prevalence of diabetes mellitus has continuously and rapidly increased, and the number of diabetic people in the adult population is predicted to double within 30 years. The prevalence of and mortality from all forms of cardiovascular diseases is two- to eight-fold higher in diabetic individuals as compared with their non-diabetic counterparts. The excess of risk attributable to diabetes related heart disease accounts for 2.9% of the all cause annual mortality. Moreover, the cardiovascular risk increases continuously throughout a wide spectrum of glycaemia starting already at what, according to present definitions, is considered as normal blood glucose levels. Therefore, screening for diabetes and hyperglycaemia is recommended in various clinical settings. Criteria for classification of hyperglycaemic states are provided together with their relation to risk for cardiovascular events. The evidence-based treatment of cardiovascular disease in patients with concomitant diabetes is summarised. Degree of under-treatment of patients with diabetes and cardiovascular diseases is discussed. Finally, the potential impact that nurses may have on the quality and efficacy of care in the vulnerable patient with combined chronic diseases such as diabetes and cardiovascular disease and the improvement of the outcomes are discussed.