Lifestyle-related cardiometabolic targets in romanian patients with type 2 diabetes: a cross-sectional analysis

Silvia Ana Luca; Raluca Mălina Bungău; Bogdan Timar

Silvia Ana Luca Department of Cardiology, Victor Babes University of Medicine and Pharmacy, Timisoara, Romania
Raluca Mălina Bungău Department of Diabetes, Pius Brinzeu Emergency Hospital, Timisoara, Romania
Bogdan Timar Second Department of Internal Medicine, Victor Babes University of Medicine and Pharmacy, Timisoara, Romania

Keywords: type 2 diabetes, cardiovascular risk, cardiometabolic control, risk factor targets

Abstract

Patients with type 2 diabetes (T2D) face an increased risk of cardiovascular disease (CVD), with risk factor burden, comorbidities, and poor disease control significantly influencing cardiovascular (CV) risk. A strategy that focuses on the simultaneous control of multiple cardiometabolic and lifestyle-related factors has demonstrated benefits in reducing adverse CV outcomes in this population. This study aims to assess the simultaneous attainment of lifestyle-related and cardiometabolic targets in a real-world cohort of adult patients with T2D from Romania. In this cross-sectional analysis, we evaluated the simultaneous attainment of lifestyle-related and cardiometabolic targets in 174 patients with T2D by using the 2023 ESC Guidelines as a reference for current best-practice recommendations. Simultaneous control of both lifestyle-related targets, namely non-smoking status and normal weight, was observed in only 12 patients (6.9%). Strict extended multifactorial control, defined as attainment of at least 4 of the 6 assessed targets, decreased significantly across higher risk categories (57.1% in the moderate-risk group, 28.0% in the high-risk group, 16.2% in the very-high-risk group, p=0.015). Smoking status was strongly associated with the probability of achieving simultaneous risk factor control, with none of the current smokers achieving four or more of the six targets, whereas 34 nonsmokers (27.9%) did so (p<0.001). Although strict extended control (≥4/6 targets) was numerically more frequent in normal-weight patients than in those with obesity (35.0% vs. 16.5%), this difference did not reach statistical significance in the unadjusted categorical comparison (p=0.152). Simultaneous attainment of lifestyle-related cardiometabolic targets was low in patients with T2D. A multidisciplinary approach emphasizing lifestyle changes and optimal risk factor management is urgently needed in these patients.