ABSTRACT
Managing diabetes is more than just managing blood sugars; it is about minimising cardiovascular risk. This requires the monitoring and managing of blood pressure, cholesterol, weight and smoking as well as determining the need for aspirin or renal protection. Algorithms, such as the Framingham Risk Score, have been devised to help define and manage patients’ cardiovascular risk. These have also improved our ability to assess not just the benefits but also the risks of intensifying medical management. Consequently, aiming for universal ‘gold standard’ targets for each risk factor for everyone with diabetes is no longer considered best practice; management should be individualised.
Managing cardiovascular risk invariably requires people with diabetes to take multiple medications every day. Presenting personalised risk information, as opposed to generic risk information, is more likely to result in patients making well-informed decisions about their cardiovascular risk self-management and adhering to their daily management regime. This chapter provides examples of how to present comprehensive, detailed but simple explanations for the pathology and management of each cardiovascular risk parameter. Each explanation can be covered in a 5- to 10-minute conversation and, more often than not, each produces long-term behavioural change in patient self-management.
