Aim: Lipid-lowering therapy (LLT) is a key factor in the prevention of cardiovascular mortality and morbidity in diabetic patients. Current guidelines have expanded the population of patients with diabetes for whom aggressive low-density lipoprotein cholesterol (LDL-C) lowering therapy should be considered. This study evaluated the management of dyslipidemia in patients with type 2 diabetes in real life.
Methods: Secondary care physicians in a tertiary center recruited 707 patients. The prevalence of statin use along with the achievement of cholesterol targets, predictors for receiving statin, and possible reasons for lack of therapy were investigated.
Results: Only 33% of the patients had received statin therapy, and this was significantly higher in those with cardiovascular disease (47% versus 27%; P<0.001). Most of the patients had LDL-C levels of >100 mg/dL (77%), with only 5% having LDL-C levels of <70 mg/dL. Forty-one percent of the patients had never been prescribed LLT previously while 26% had been prescribed this type of therapy in the past but had stopped using it. The most frequent reason for discontinuation of the statin therapy was a physician's advice to stop the medication. The patients taking statins had similar LDL-C levels as those who had never been prescribed statins and those who had discontinued their use of statins on the advice of a physician.
Conclusion: The majority of diabetic patients are undertreated with statins and minority of them achieve LDL-C target levels. Our findings suggest that there is a large discrepency between evidence-based recommendations and physicians' treatment attitudes.