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Persistent lipid abnormalities in statin‐treated patients with diabetes mellitus in Europe and Canada: results of the Dyslipidaemia International Study
Author(s) -
Leiter L. A.,
Lundman P.,
da Silva P. M.,
Drexel H.,
Jünger C.,
Gitt A. K.
Publication year - 2011
Publication title -
diabetic medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.474
H-Index - 145
eISSN - 1464-5491
pISSN - 0742-3071
DOI - 10.1111/j.1464-5491.2011.03360.x
Subject(s) - medicine , metabolic syndrome , diabetes mellitus , simvastatin , statin , ezetimibe , cholesterol , triglyceride , endocrinology , national cholesterol education program
Diabet. Med. 28, 1343–1351 (2011) Abstract Aim To assess the prevalence of persistent lipid abnormalities in statin‐treated patients with diabetes with and without the metabolic syndrome. Methods This was a cross‐sectional study of 22 063 statin‐treated outpatients consecutively recruited by clinicians in Canada and 11 European countries. Patient cardiovascular risk factors, risk level, lipid measurements and lipid‐modifying medication regimens were recorded. Results Of the 20 129 subjects who had documented diabetes and/or metabolic syndrome status, 41% had diabetes (of whom 86.8% also had the metabolic syndrome). Of those with diabetes, 48.1% were not at total cholesterol target compared with 58% of those without diabetes. Amongst those with diabetes, 41.6 and 41.3% of those with and without the metabolic syndrome, respectively, were not at their LDL cholesterol goal relative to 54.2% of those with metabolic syndrome and without diabetes, and 52% of those with neither condition. Twenty per cent of people with diabetes but without the metabolic syndrome were not at the optimal HDL cholesterol level compared with 9% of those with neither condition. Of people with diabetes and the metabolic syndrome, 49.9% were not at optimal triglyceride level relative to 13.5% of people with neither diabetes nor the metabolic syndrome. Simvastatin was the most commonly prescribed statin (> 45%) and the most common statin potency was 20–40 mg/day (simvastatin equivalent). Approximately 14% of patients were taking ezetimibe alone or in combination with a statin. Conclusions Despite evidence supporting the benefits of lipid modification and international guideline recommendations, statin‐treated patients with diabetes had a high prevalence of persistent lipid abnormalities. There is frequently room to optimize therapy through statin dose up‐titration and/or addition of other lipid‐modifying therapies.