Lack of improvement in the treatment of hyperlipidemia among patients with type 2 diabetes.
OBJECTIVE
We investigated the adequacy of treatment of hyperlipidemia in patients with type 2 diabetes, and assessed the temporal trends in adherence to published guidelines.


METHODS
We performed a post hoc analysis of 501 patients enrolled in the Appropriate Blood Pressure Control in Diabetes trial. All patients had fasting lipid profiles at baseline and during the 5 years (1993 to 1998) of the trial. Achieving the National Cholesterol Education Panel's goals for hyperlipidemia management was the primary outcome.


RESULTS
The percentage of patients with a low-density lipoprotein (LDL) cholesterol level less than 130 mg/dL was 53% (n = 266) at baseline and 54% (n = 270) at the end of 5 years (P = 0.75). Almost 14% (n = 69) of these patients continued to have an LDL cholesterol level greater than 160 mg/dL at the completion of the study. Only 19% (n = 25) of the 133 patients with known coronary artery disease had an LDL cholesterol level less than 100 mg/dL at baseline, and only 16% (n = 21) achieved this level at the completion of the study (P = 0.37).


CONCLUSIONS
Although prevention of cardiovascular disease in patients with diabetes is a public health priority, our results suggest that hyperlipidemia is being treated suboptimally.
Mehler
Philip S
PS
Denver Health, Denver, Colorado 80204, USA. Pmehler@dhha.org
Esler
Anne
A
Estacio
Raymond O
RO
MacKenzie
Thomas D
TD
Hiatt
William R
WR
Schrier
Robert W
RW
D008078:Cholesterol, LDL / Q000097:blood; D003324:Coronary Artery Disease / Q000209:etiology; D003924:Diabetes Mellitus, Type 2 / Q000150:complications*; D005260:Female; D019983:Guideline Adherence; D006801:Humans; D006949:Hyperlipidemias / Q000097:blood / Q000150:complications / Q000188:drug therapy*; D000960:Hypolipidemic Agents / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D017410:Practice Guidelines as Topic
D008078:Cholesterol, LDL; D000960:Hypolipidemic Agents