Clinician prescription of lipid-lowering drugs and achievement of treatment goals in patients with newly diagnosed type 2 diabetes mellitus. Issue 1 (10th February 2021)

• Record Type: Journal Article
• Authors: García-Ulloa, Ana Cristina; Lechuga-Fonseca, Claudia; Del Razo-Olvera, Fabiola Mabel; Aguilar-Salinas, Carlos Alberto; Galaviz, Karla Ivette; Narayan, K M Venkat; Hernández-Jiménez, Sergio
• Other Names: author non-byline.; Alcántara-Garcés María Teresa author non-byline.; Arcila-Martínez Denise author non-byline.; Arizmendi-Rodríguez Rodrigo author non-byline.; Díaz-Pineda Michelle author non-byline.; Valle-Ramírez Humberto Del author non-byline.; García Arturo Flores author non-byline.; Galván-Pérez Adriana author non-byline.; Garnica-Carrillo Fernanda author non-byline.; González-Flores Eduardo author non-byline.; Granados-Arcos Mariana author non-byline.; Infanzón-Talango Héctor author non-byline.; Landa-Anell María Victoria author non-byline.; López-Reyes Arely author non-byline.; Melgarejo-Hernández Marco Antonio author non-byline.; Pérez-Peralta Liliana author non-byline.; Ríos-Villavicencio Sofía author non-byline.; Parra David Rivera de la author non-byline.; Rojas-Torres Francis author non-byline.; Sainos-Muñoz Sandra author non-byline.; Sierra-Esquivel Alejandra author non-byline.; Velasco-Pérez María Luisa author non-byline.; Velázquez-Jurado Héctor author non-byline.; Villegas-Narvaez Andrea author non-byline.; Urbina-Arronte Luz Elena author non-byline.; Zurita-Cortés Verónica author non-byline.; Gómez-Pérez Francisco J author non-byline.; Kershenobich-Stalnikowitz David author non-byline.
• Is Part Of: BMJ open diabetes research and care. Volume 9:Issue 1(2021)
• Publication Date: 2021-02-10
• Subjects: lipids -- treatment outcome; Diabetes -- Periodicals; 616.462005
• DOI: 10.1136/bmjdrc-2020-001891
• Languages: English
• ISSNs: 2052-4897

Abstract

Abstract : Introduction: Lipid control is essential in type 2 diabetes mellitus (T2DM). The aim of this study is to investigate factors associated with lipid therapy adherence and achievement of goals in real-life setting among patients with recently diagnosed T2DM. Research design and methods: This is a longitudinal analysis in a center of comprehensive care for patients with diabetes. We include patients with T2DM, <5 years of diagnosis, without disabling complications (eg, amputation, myocardial infarct, stroke, proliferative retinopathy, glomerular filtration rate <60 mL/min/m 2 ) and completed 2-year follow-up. The comprehensive diabetes care model includes 9 interventions in 4 initial visits and annual evaluations. Endocrinologists follow the clinic's guideline and adapt therapy to reach risk-based treatment goal. The main outcome measures were the proportion of patients meeting low-density lipoprotein cholesterol (c-LDL) (<100 mg/dL) and triglycerides (<150 mg/dL) and proportion of patients taking statin, fibrate or combination at baseline, 3 months and annual evaluations. Results: We included 288 consecutive patients (54±9 years, 53.8% women), time since T2DM diagnosis 1 (0–5) year. Baseline, 10.8% patients were receiving statin therapy (46.5% moderate-intensity therapy and 4.6% high-intensity therapy), 8.3% fibrates and 4.2% combined treatment. The proportion of patients with combined treatment increased to 41.6% at 3 months, decreased to 20.8% at 1 year and increased to 38.9% at 2 years of evaluation. Patients receiving treatment met LDL and triglycerides goals at 3 months (17% vs 59.7%, relative ratio (RR)=0.89, 95% CI 0.71 to 1.12), at 1 year (17% vs 26.7%, RR=0.62, 95% CI 0.41 to 0.95) and at 2 years (17% vs 29.9%, RR=0.63, 95% CI 0.43 to 0.93). Main reasons for medication suspension: patient considered treatment was not important (37.5%) and other physician suspended treatment (31.3%). Conclusion: 88.2% of patients with T2DM required lipid-lowering drugs. Education for patients and physicians is critical to achieve and maintain diabetes goals. Trial registration number: NCT02836808 .