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

Abstract

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

Acknowledgment

The authors would like to acknowledge the editorial and analytic support of ROCK Medical Communications.

Disclosure

The authors analysed and interpreted the data and wrote the manuscript. Abbott Healthcare Products Limited conceived of and funded the original audit and the preparation of the manuscript. Abbott did not actively contribute to the content but reviewed the final piece for scientific accuracy. Dr Feher and Dr Munro have received honoraria for research and consultancy from pharmaceutical firms marketing lipid lowering drugs - Abbott, Pfizer and MSD. Mark Greener has no other conflicts of interest in this work.