QJM Advance Access originally published online on July 17, 2007
QJM 2007 100(9):547-550; doi:10.1093/qjmed/hcm058
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Antiplatelet drug use in a diabetic clinic
From the Department of Diabetes and Endocrinology, University Hospital Aintree, Liverpool, UK
Address correspondence to Mrs A. Woodward, Diabetes and Endocrinology, 3rd Floor, Clinical Sciences Centre, University Hospital Aintree, Longmoor Lane, Liverpool L9 7AL. email: annwoodward4{at}btinternet.com
Received 7 March 2007 and in revised form 3 May 2007
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Abstract |
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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/m2 and HbA1c 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.