The Management of Dyslipidaemia in Patients with Type 2 Diabetes Mellitus Receiving Lipid-Lowering Drugs: A Sub-Analysis of the CEPHEUS Findings

Author(s): Abdullah Shehab* , Khalid Al-Rasadi , Mohamed Arafah , Ali T. Al-Hinai , Wael Al Mahmeed , Akshaya Srikanth Bhagavathula , Omer Al Tamimi , Shorook Al Herz , Faisal Al Anazi , Khalid Al Nemer , Othman Metwally , Akram Alkhadra , Mohammed Fakhry , Hossam Elghetany , Abdel Razak Medani , Afzal Hussein Yusufali , Obaid Al Jassim , Omar Al Hallaq , Fahad Omar Ahmed S. Baslaib , Mahmoud Alawadhi , Haitham Amin , Khamis Al-Hashmi , Abderrahim Oulhaj .

Journal Name: Current Vascular Pharmacology

Volume 16 , Issue 4 , 2018

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Abstract:

Background: Dyslipidaemia is a risk factor for macrovascular complications in patients with type 2 diabetes mellitus (T2DM). Our aim was to assess the use of lipid lowering drugs (LLDs) in patients with T2DM and co-existing dyslipidaemia.

Method: A multicentre, non-interventional survey conducted in 6 Middle Eastern countries (Bahrain, Oman, Qatar, United Arab Emirates, Kingdom of Saudi Arabia and Kuwait). Patients with T2DM (n = 3338) taking LLD treatment for ≥3 months with no dose change for ≥6 weeks were enrolled.

Results: The mean age (SD) of T2DM patients was 56.6 ±10.6 years; the majority (99%) were on statin monotherapy. Only 48% of these patients achieved their low density lipoprotein cholesterol (LDL-C) goal and 67.7% of the patients had a high cardiovascular disease (CVD) risk according to the National Cholesterol Education Program (NCEP) Adult Treatment Panel (ATP) III guidelines. Of those who achieved LDL-C goals (n=1589), approximately one-third were at very high CVD risk and the patients who had received statin monotherapy showed the highest proportion in LDL-C goal attainment, followed by those treated with fibrate monotherapy. In a multivariate logistic regression model, taking drugs daily (odds ratio, OR: 1.64, 95% CI 1.25, 2.15) and older age (OR: 1.09, 95% CI 1.01, 1.18) were significantly associated with better odds of attaining LDL-C target. In contrast, patients with higher levels of ApoA1 (OR: 0.73, 95% CI [0.67,0.79]), Metabolic Syndrome (OR: 0.64, 95% CI [0.53, 0.76]), higher CV risk (OR: 0.33, 95% CI 0.27, 0.41), those who forgot to take their medication (OR: 0.74, 95% CI 0.62,0.88) and those who stopped taking medication when cholesterol became normal (OR: 0.67, 95% CI 0.55,0.82) were significantly associated with lower odds of attaining LDL-C target.

Conclusion: The results of this study highlight the suboptimal management of dyslipidaemia in T2DM patients at high and very high risk of CVD.

Keywords: Centralized pan-middle east survey (CEPHEUS), dyslipidaemia, lipid-lowering drugs (LLDs), low-density lipoprotein cholesterol (LDL-C), type 2 diabetes mellitus (T2DM), middle east, cardiovascular disease (CVD).

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Article Details

VOLUME: 16
ISSUE: 4
Year: 2018
Page: [368 - 375]
Pages: 8
DOI: 10.2174/1570161115666170705153815
Price: $58

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