CV risk in diabetes: GPs’ top questions answered

What the latest research and RACGP guidelines mean for you
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Content produced by Australian Doctor Group with an independent educational grant from Boehringer Ingelheim Pty Limited and Eli Lilly Australia Pty Limited.

GPs focus on oral hypoglycaemic agents to reduce blood glucose when managing type 2 diabetes, but do they consider them in the context of reducing CV risk? Do we require a change in mindset that a hypoglycaemic agent can do both?

Australian Doctor polled GPs to find out their key questions about managing cardiovascular risk in type 2 diabetes (T2DM) patients. Then we asked an expert to answer them.

Here’s what we learned from Queensland GP Dr Gary Deed, chair of the RACGP’s diabetes specific interest network and co-editor of the latest RACGP guidelines, General practice management of type 2 diabetes: 2016–18.

Q: Guidelines recommend putting high-risk patients on statins, low-dose aspirin, and anti-hypertensives – but should GPs consider these for all patients, regardless of CV risk assessment?
A: No. The latest RACGP Guidelines released in 2016, support that risk assessment must be individualised.1 If there is an estimated elevated absolute risk (established CVD disease) or relative risk (AUSDRISK* score >12) then each of these interventions should be considered against the risks of using any such interventions in the patient. That said, low-dose aspirin in primary prevention is still controversial.