A Woodward1, D Bayley, L Overend, G Gill. 1. Diabetes and Endocrinology, 3rd Floor, Clinical Sciences Centre, University Hospital Aintree, Longmoor Lane, Liverpool L9 7AL, UK. annwoodward4@btinternet.com
Abstract
BACKGROUND: There are definite indications for antiplatelet therapy in diabetes in the presence of large-vessel disease, but in the absence of large-vessel disease, the evidence is less clear. There is also evidence that antiplatelet therapy is under-prescribed. AIM: To investigate the use of antiplatelet drugs in patients attending a diabetic clinic in a large teaching hospital. DESIGN: Retrospective case-note survey. METHODS: We examined the case-notes of 300 consecutive diabetic patients, to determine whether antiplatelet therapy was being used in appropriate patients, including those with established large-vessel disease, hypertension and nephropathy or microalbuminuria. RESULTS: The patients were of mean +/- SD age 61 +/- 13 years, diabetes duration 10 +/- 8 years, BMI 31.4 +/- 6.7 kg/m(2) and HbA(1c) 8.3 +/- 1.5%; 276 (92%) had type 2 diabetes, and 162 (54%) were male. Antiplatelet drugs were being taken by 157 (52%) who fulfilled the survey standard for treatment; a further 83 (28%) met the survey standard but were not receiving treatment, of whom 48 (16% of the total group) had no valid contraindication. DISCUSSION: A significant minority of diabetic patients are being denied antiplatelet drugs despite good indications.
BACKGROUND: There are definite indications for antiplatelet therapy in diabetes in the presence of large-vessel disease, but in the absence of large-vessel disease, the evidence is less clear. There is also evidence that antiplatelet therapy is under-prescribed. AIM: To investigate the use of antiplatelet drugs in patients attending a diabetic clinic in a large teaching hospital. DESIGN: Retrospective case-note survey. METHODS: We examined the case-notes of 300 consecutive diabeticpatients, to determine whether antiplatelet therapy was being used in appropriate patients, including those with established large-vessel disease, hypertension and nephropathy or microalbuminuria. RESULTS: The patients were of mean +/- SD age 61 +/- 13 years, diabetes duration 10 +/- 8 years, BMI 31.4 +/- 6.7 kg/m(2) and HbA(1c) 8.3 +/- 1.5%; 276 (92%) had type 2 diabetes, and 162 (54%) were male. Antiplatelet drugs were being taken by 157 (52%) who fulfilled the survey standard for treatment; a further 83 (28%) met the survey standard but were not receiving treatment, of whom 48 (16% of the total group) had no valid contraindication. DISCUSSION: A significant minority of diabeticpatients are being denied antiplatelet drugs despite good indications.