Treating to target in type 2 diabetes

Patients with type 2 diabetes have a three-fold increased risk of developing vascular disease with death in 75% due to a vascular complication. Large prospective studies have demonstrated the benefits of treating patients with type 2 diabetes to strict targets regarding blood pressure (BP), lipids and glucose. Using both American Diabetes Association and Joint British Societies/Guidelines we assessed the effectiveness of this 'treat-to-target' policy in diabetic patients attending secondary care. Of 321 patient notes analysed 54-87% were within target for total cholesterol, 80-84% for LDL cholesterol, 77% for HDL cholesterol, 51% for triglycerides, 44-61% for systolic BP, 62% for diastolic BP and 30-44% for HbA_1C. In the secondary care setting we are performing well for lipids, less well for BP and poorly for HbA_1C.