Background and purpose: Both lipid-lowering and anti-hyperglycemic therapy are of paramount importance in secondary cardiovascular prevention in diabetes mellitus (DM). Good patient information and a high level of informedness is required for shared decision-making. We thus aimed to analyze the knowledge and attainment of lipid-lowering and anti-hyperglycemic treatment goals and perceived level of informedness in very high-risk patients with cardiovascular disease (CVD) and DM.

Methods: Hospitalized patients with a history of both atherosclerotic cardiovascular disease and diabetes mellitus completed a questionnaire in a cross-sectional study, assessing level of patient informedness on predefined disease-related topics of CVD and DM and knowledge of treatment goals for lipid-lowering (low-density lipoprotein cholesterol [LDL-C]) and anti-hyperglycemic therapy (glycated hemoglobin [HbA1c]). Blood serum samples were analyzed for LDL-C and HbA1c levels.

Results: A total of 210 patients (mean age 75±9 years; 71.4% male) with CVD and DM were included. Coronary artery disease (89.5%) was the most common CVD; 96.7% of the patients presented with type 2 diabetes. Highest perceived level of informedness was found for the topics of treatment for CVD (72.4% well informed or informed) and lifestyle adjustment for DM (81.0% well informed or informed). For CVD and DM the lowest perceived level of informedness was found for the topic of support, helplines and information sources (50.9% well informed or informed for CVD and 71.9% for DM). Perceived levels of informedness differed significantly between CVD and DM except for the topic of treatment with higher levels reported for DM (p<0.05 for the topics of course of the disease, cause of the disease, complications, lifestyle adjustment, and support, helplines and information sources; p=0.05 for treatment). Significantly more participants named the correct anti-hyperglycemic treatment goal compared to treatment goal of LDL-C-lowering (52.9% vs. 2.4%; p<0.01). Goals for anti-hyperglycemic treatment were reached more frequently than goals for LDL-C-lowering therapy (60.6% vs. 40.0%; p<0.01).

Conclusion: In very high-risk patients suffering from both conditions, perceived level of informedness on disease-related topics was lower for CVD than for DM. Knowledge of treatment goals for LDL-C-lowering and their attainment were considerably lower than for anti-hyperglycemic therapy. Improving knowledge of treatment goals might improve quality of care in patients with CVD and DM.