Use of non‐LDL‐C lipid‐lowering medications in patients with type 2 diabetes. Issue 3 (14th April 2020)

• Record Type: Journal Article
• Authors: Arnold, Suzanne V.; Gosch, Kensey; Wong, Nathan D.; Hejjaji, Vittal; Goyal, Abhinav; Leiter, Lawrence A.; Kosiborod, Mikhail
• Is Part Of: Endocrinology, diabetes & metabolism. Volume 3:Issue 3(2020)
• Page Start: n/a
• Page End: n/a
• Publication Date: 2020-04-14
• Subjects: diabetes mellitus -- lipids -- quality of care -- triglycerides; Endocrinology -- Periodicals; Diabetes -- Periodicals; Metabolism -- Periodicals; 616.4
• DOI: 10.1002/edm2.126
• Languages: English
• ISSNs: 2398-9238

Abstract

Abstract: Background: A number of non‐low‐density lipoprotein cholesterol lipid abnormalities are associated with type 2 diabetes and insulin resistance, which may lead practitioners to use medications targeting these abnormal lipid fractions despite a lack of evidence or guideline recommendations. Methods and Results: Among 382 921 US patients with type 2 diabetes (69% with cardiovascular disease, 76% on a statin), 95 995 (26%) were on some nonstatin lipid‐lowering medication—19 265 (5%) on niacin, 32 919 (9%) on a fibrate and 69 513 (18%) on fish oil. Use of all three medications was stable over time and higher in patients with cardiovascular disease and with higher triglyceride levels, although even among patients with triglyceride levels <2.3 mmol/L, 6% were on a fibrate and 17% were on fish oil. Conclusion: As clinical trials demonstrate little to no cardiovascular benefit from taking these medications, greater attention is needed to focus the use of lipid‐lowering medications to those with proven benefit. Abstract : A number of non‐low‐density lipoprotein cholesterol lipid abnormalities are associated with type 2 diabetes and insulin resistance, which may lead practitioners to use medications targeting these abnormal lipid fractions despite a lack of evidence or guideline recommendations. Among 382 921 US patients with type 2 diabetes (69% with cardiovascular disease, 76% on a statin), 95 995 (26%) were on some nonstatin lipid‐lowering medication—19 265 (5%) on niacin, 32 919 (9%) on a fibrate and 69 513 (18%) on fish oil. Use of all three medications was stable over time and higher in patients with cardiovascular disease and with higher triglyceride levels, although even among patients with triglyceride levels <1.7 mmol/L, 5% were on a fibrate and 16% were on fish oil. As clinical trials demonstrate little to no cardiovascular benefit from taking these medications, greater attention is needed to focus the use of lipid‐lowering medications to those with proven benefit.