Physician attitudes and practices and patient awareness of the cardiovascular complications of diabetes

J Am Coll Cardiol. 2002 Nov 20;40(10):1877-81. doi: 10.1016/s0735-1097(02)02529-9.


Objectives: Studies were conducted to: 1) assess physicians' attitudes and practices in managing cardiovascular disease (CVD) risks in diabetes; and 2) determine the awareness of CVD risks among diabetic patients.

Background: Cardiovascular disease is the leading cause of premature death among diabetic patients. As diabetes is often seen as a "glucose-centric" disease, it is unclear whether diabetic patients are talking with their doctors about CVD and other key clinical parameters of diabetes care such as blood pressure and cholesterol.

Methods: An online survey was completed by a nationally representative sample of 900 physicians. The 95% confidence interval is approximately +/-2.5%. Before this study, a telephone survey of 2,008 people with diabetes was conducted using random, direct-dial screenings of U.S. households.

Results: Ninety-one percent of physicians believe that their patients with diabetes are "very" or "extremely" likely to have a cardiovascular event. Although physicians report discussing CVD risk factors with 88% of their diabetic patients, they perceive their diabetic patients as being only moderately knowledgeable about their increased CVD risks. Sixty-eight percent of the people with diabetes do not consider CVD to be a serious complication of diabetes; they are more likely to be aware of complications such as blindness (65%) or amputation (36%) rather than heart disease (17%), heart attack (14%), or stroke (5%). Physicians perceive "poor compliance" with behavioral modifications and medication regimens as the greatest barriers to the management of CVD risks in diabetic patients.

Conclusion: Materials should be made available to help facilitate communication about CVD risks, and strategies for improving compliance with life-style modifications and multiple drug therapies should be explored. Efforts should continue to promote a comprehensive approach to the management of diabetes to include aggressive control of blood glucose and other CVD risk factors.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Attitude*
  • Awareness / physiology
  • Blood Pressure / physiology
  • Cardiovascular Diseases / complications*
  • Cardiovascular Diseases / epidemiology
  • Cardiovascular Diseases / therapy
  • Cholesterol / blood
  • Data Collection
  • Diabetes Complications*
  • Diabetes Mellitus / epidemiology
  • Diabetes Mellitus / therapy
  • Diabetic Angiopathies / psychology*
  • Humans
  • Middle Aged
  • Patient Education as Topic
  • Physician-Patient Relations
  • Physicians*
  • Randomized Controlled Trials as Topic
  • Risk Factors
  • United States / epidemiology


  • Cholesterol