It is well known that people with T2D have an increased risk of developing cardiovascular diseases and associated clinical complications such as peripheral arterial disease, stroke, and heart failure. Given the important relationship between diabetes and CVD, examining CVD awareness and knowledge in people living with T2D is crucial, as it can help to reduce CVD-related morbidity and mortality in people with diabetes.
To investigate global CVD awareness and knowledge, the International Diabetes Federation (IDF) initiated the Taking Diabetes to Heart (TD2H) study in 2017 in collaboration with Novo Nordisk.
The study, consisting of an online survey, was conducted between September 2017 and May 2018. Responses were received from 12,695 people with T2D in over 130 countries. Findings showed that about 10% of respondents did not know about CVD and its associated risk factors. Surprisingly, about one-third considered themselves at no risk or low risk of CVD, while the majority reported that they had at least one CVD risk factor and had experienced one or more CVD events.
Cardiovascular disease (CVD) is the leading cause of death in people with type 2 diabetes (T2D), and yet, people with type 2 diabetes are unaware of the condition and most alarmingly, don’t even know they live with it.
A large number of respondents indicated they rely on their healthcare providers and diabetes clinics to obtain information about CVD, and the majority were satisfied with the quality of the information that they received. However, one in six (17%) respondents reported that they have never discussed T2D and CVD with their healthcare providers. Even among those who had a conversation with their healthcare providers, only a small proportion had it “at the time” or “soon after” T2DM diagnosis (25% and 13%, respectively).
In addition, respondents indicated that they need information about diabetes self-management, the importance of diet and exercise for preventing CVD, as well as general information about signs and symptoms of CVD to better understand the association between T2D and CVD. The findings highlight the important role of healthcare providers in regards to CVD knowledge among people living with T2D, as well as a need for education strategies to increase this knowledge.
By translating these findings, IDF aims to inform policymakers and healthcare providers about CVD awareness/knowledge among people living with T2DM and provide evidence-based recommendations/guidelines to improve the quality of care and consequently quality of life in this population.
A comprehensive report with regional and country-specific results from the Taking Diabetes to Heart study will be published in December 2018.
Pouya Saeedi is Data Analyst and Coordinator at the International Diabetes Federation.
An interview with Stela Prgomelja
While risk factors for cardiovascular disease (CVD) are well-established in people with type 2 diabetes, CVD is the most common cause of premature death and disability among patients with type 1 diabetes.1 Although many conventional CVD risk factors apply in type 1 diabetes, hyperglycemia is an important risk factor second only to age, as well as blood pressure, triglycerides and most significantly, diabetic nephropathy.2
IDF spoke with Stela Prgomelja, Vice President of the Diabetes Association of Serbia and a member of IDF’s Blue Circle Voices, about how she manages her lifestyle with diabetes and high blood pressure, interacts with healthcare professionals and her top tips for others.
Can you tell us about yourself? When and how did you find out you have diabetes and then high blood pressure?
I was a child when my parents started to notice that I was thirsty and hungry all the time, urinating a lot. I was five years old when the doctors diagnosed me with type 1 diabetes.
During one of my regular check-ups, it was found that I had high blood pressure. I was 27. Since then, I have been dealing with my blood pressure and diabetes.
Have you had discussions with healthcare professionals about cardiovascular risks?
I’ve had discussions with all my healthcare professionals. They have all pointed out the benefits of normal blood pressure and the possible damages if not treated. I am very much aware of the complications that high blood pressure with high glucose can bring, such as stroke, heart attack or vision loss.
We are a team. As a patient you need to get educated about your condition. As a healthcare provider, you need to explain every single aspect of someone's condition and offer the best treatment in that moment, for that person.
Is there anything you would have liked to have been advised on earlier?
I wish I have known better about the negative impact of adding salt to my food. It can really have a negative impact on blood pressure.
Where did you go to get help? Who was your best advisor?
My best advisors were my cardiologist and my nephrologist. Both were very motivated to treat my condition in the best way possible. Sometimes, but rarely, their opinions were not compatible, so I asked for more explanation in order to make the best decision for me.
What is your lifestyle strategy to manage your blood pressure and diabetes?
Food is one of the greatest elements of good self-management, both for blood pressure and blood glucose. I love to cook tasty, but healthy meals. Also, it is important to always move, even a brisk walk is good for the body.
What is the role of healthcare provider for you in managing your diabetes?
We are a team. As a patient you need to get educated about your condition. As a healthcare provider, you need to explain every single aspect of someone’s condition and offer the best treatment in that moment, for that person.
Do you have any top tips for people living with diabetes and high blood pressure?
Blood Glucose numbers are as equally important as blood pressure numbers. Don’t forget that!
Stela has created a YouTube channel in English and Serbian detailing carb counting of everyday foods: https://www.youtube.com/user/stela08/
Lucy Hammond is currently an intern at the global office of the International Diabetes Federation with the Policy and Programmes department.
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