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Patients with diabetes may not receive best treatment to lower heart disease risk
Date:12/18/2012

ANN ARBOR, Mich. For some people with diabetes, there may be such a thing as too much care.

Traditional treatment to reduce risks of heart disease among patients with diabetes has focused on lowering all patients' blood cholesterol to a specific, standard level. But this practice may prompt the over-use of high-dose medications for patients who don't need them, according to new research from the VA Ann Arbor Healthcare System (VAAAHS) and the University of Michigan Health System.

The study encourages a more individualized approach to treatment that adjusts treatment according to the patient in order to improve the quality of care. The findings appear in Circulation: Cardiovascular Quality and Outcomes.

Authors also suggest that blanket goals routinely used to lower heart attack risks may unnecessarily expose some patients to potential adverse side effects of high-dose medications. Researchers also note that when these standard goals are used to assess whether a health provider delivered high quality care, they may encourage overly aggressive treatment.

"We want patients to get the treatment they need to prevent heart attacks and cardiovascular issues but we don't want to expose them to additional treatment risks without strong evidence of the benefits," says senior author Eve Kerr, M.D., director of the Center for Clinical Management Research at the VAAAHS, professor of internal medicine at the U-M Medical School and a member of the U-M Institute for Healthcare Policy and Innovation.

"We need to move away from a one-size-fits-all performance measure that misses the point of providing appropriate treatment."

Managing cholesterol is especially important for people with type 2 diabetes who often have an increased risk for a heart attack. This is especially true for people age 50 and over.

Physicians commonly aim to lower blood cholesterol for all patients with diabetes to below 100 mg/dl.
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Contact: Beata Mostafavi
bmostafa@umich.edu
734-764-2220
University of Michigan Health System
Source:Eurekalert  

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