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Persistent hypertriglyceridemia in statin-treated patients with type 2 diabetes mellitus

Authors Feher M, Greener M, Munro N

Received 15 June 2012

Accepted for publication 24 October 2012

Published 10 January 2013 Volume 2013:6 Pages 11—15


Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 2

Michael Feher,1–3 Mark Greener,4 Neil Munro1–3,5

Beta Cell Diabetes Centre, Chelsea and Westminster Hospital, London, 2Diabetes Therapies Evaluation Network, London, 3CSRI, Warwick University, Warwick, 4ROCK Medical Communications, Richmond, 5Department of Health Care Management, University of Surrey, Guildford, Surrey, UK

Purpose: This paper reports the results of an audit that assessed the prevalence of residual hypertriglyceridemia and the potential need for intensified management among patients with statin-treated type 2 diabetes mellitus (T2DM) in primary care in the UK.
Patients and methods: A cross-sectional, observational, systematic audit of patients with diagnosed diabetes from 40 primary care practices was undertaken. The audit collected basic demographic information and data on prescriptions issued during the preceding 4 months. T2DM patients were stratified according to the proportion that attained European Society of Cardiology treatment targets.
Results: The audit collected data from 14,652 patients with diagnosed diabetes: 89.5% (n = 13,108) of the total cohort had T2DM. Of the people with T2DM, 22.2% (2916) were not currently receiving lipid-lowering therapy. Up to approximately 80% of these people showed evidence of dyslipidemia. Among the group that received lipid-lowering therapy, 94.7% (9647) were on statin monotherapy, which was usually simvastatin (69.5% of patients receiving statin monotherapy; 6707). The currently available statins were prescribed, with the most common dose being 40 mg simvastatin (44.2%; 4267). Irrespective of the statin used, around half of the patients receiving statin monotherapy did not attain the European Society of Cardiology treatment targets for triglycerides, low-density lipoprotein, high-density lipoprotein, and total cholesterol.
Conclusion: T2DM patients managed in UK primary care commonly show persistent lipid abnormalities. Clinicians need to optimize compliance with lipid-lowering and other medications. Clinicians also need to consider intensifying statin regimens, prescribing additional lipid-modifying therapies, and specific treatments aimed at triglyceride lowering to improve dyslipidemia control in statin-treated patients with T2DM.

Keywords: triglycerides, lipid-lowering treatment, diabetic dyslipidemia, simvastatin, audit

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