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New tool for CHD risk in diabetes

UK researchers have developed a new risk tool that accurately predicts the likelihood of coronary events in patients with diabetes.

An electronic version of the tool ­ described in the June issue of Diabetes Care ­ is currently being developed for distribution to GPs.

The researchers said it would provide GPs with a much

more accurate estimate of CHD risk in diabetes patients than the discredited Framingham charts.

Study leader Dr Peter Donnan, senior lecturer at the Tayside Centre for General Practice, University of Dundee, told Pulse: 'GPs use devices like this based on Framingham and do ad hoc modification saying "this patient has diabetes so I'll just increase it slightly".

'The purpose of this study is to give a more accurate risk. There is a need for such an algorithm.'

A pilot version of Dr Donnan's diabetes tool has been well received by GPs in Tayside and has also proven useful to show patients their risk. 'It can be used as a health education tool as well,' he added.

Dr Donnan derived his algorithm using data from 4,569 patients with type 2 diabetes with no previous CHD events. CHD risk was defined as fatal or non-fatal myocardial infarctions or CHD death and a total of 243 subjects had one of these over a follow-up period from 1995 to 2004.

Significant predictors include age on diagnosis, duration of diabetes, sex and smoking status (see box, below).

As well as allowing clinicians to take early action to decrease risk, the tool will help health planning and clinical trial design, say the researchers.

CHD risk

factors in diabetes tool

· Duration of diabetes

· Age at diagnosis

· Total cholesterol

· Smoking status

· Sex

· HbA1C

· Systolic blood pressure

· Treated hypertension

· Height

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