Poor Control of Risk Factors for Vascular Disease Among Adults With Previously Diagnosed Diabetes

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Abstract
Diabetes presents a significant public health burden on the basis of its increased morbidity, mortality, and economic costs.1,2 Individuals with diagnosed diabetes are at an increased risk for vascular disease, including microvascular complications (eg, retinopathy, neuropathy, and nephropathy) and macrovascular complications (eg, coronary heart disease and stroke), and lower extremity amputations.3-6 Improved glycemic control clearly reduces the risk of microvascular disease among individuals with diagnosed diabetes and is associated with lower risk of atherosclerosis and macrovascular disease.4,7-12 While treatment for individuals with diabetes has traditionally focused on control of glycemia to reduce these vascular complications, there is growing evidence highlighting the importance of controlling blood pressure and cholesterol levels.9,13-16 In addition, while intensive control of glycemia, blood pressure, and cholesterol levels all improve health outcomes for individuals with diabetes, control of blood pressure has been reported to be the most cost-effective intervention.17