title: The under-use of statin in type 2 diabetic patients attending diabetic clinics in Italy.
abstract: OBJECTIVE
  The greatest decrease in mortality from cardiovascular disease (CAD) that can be achieved with 3-hydroxy-3-methylglutaryl-coenzyme A reductase inhibitors (statins) is seen in patients with the highest risk for CAD, such as diabetics. Yet, there is evidence for inadequate use of drug therapies to achieve lipid goals. Our aims were to: (1) assess the prevalence of statin use in patients attending diabetic clinics and (2) correlate the use of statins with their risk and clinical status.
  
  
  RESULTS
  Of 9921 patients included, only 20.4% of them were receiving statin therapy. Statins were more progressively prescribed in those with risk factors additional to that of diabetes. Patients under statin treatment were older, mostly type 2 diabetics, more hypertensive and hyperlipidemic, had a higher prevalence of both macro- and microvascular disease. Among those with a total cholesterol concentration above 252 mg/dl, statin treatment was given only to 60% of diabetic patients with prior myocardial infarction, 56% of those with angina, 66% of those having had prior revascularization procedure, 54% of those with cerebrovascular disease and 51% of those with peripheral artery disease.
  
  
  CONCLUSIONS
  At least in Italy, statins are not prescribed to the majority of diabetic patients, and a substantial proportion of patients not treated with statins present significant macro- and microvascular complications.
authors.affiliation: Department of Clinical and Experimental Medicine, University of Padova, School of Medicine, Via Giustiniani 2, 35128 Padova, Italy. angelo.avogaro@unipd.it
authors.forename: Angelo
authors.initials: A
authors.lastname: Avogaro
authors.forename: Pietro
authors.initials: P
authors.lastname: Guida
authors.forename: Carlo
authors.initials: C
authors.lastname: Giorda
authors.forename: Edoardo
authors.initials: E
authors.lastname: Mannucci
authors.forename: Gerardo
authors.initials: G
authors.lastname: Medea
authors.forename: Marco
authors.initials: M
authors.lastname: Comaschi
authors.forename: Mario
authors.initials: M
authors.lastname: Velussi
authors.forename: Guglielmo
authors.initials: G
authors.lastname: Armienti
authors.forename: Roberta
authors.initials: R
authors.lastname: Zucchetti
mesh_terms: D000328:Adult; D000368:Aged; D002318:Cardiovascular Diseases / Q000209:etiology; D008078:Cholesterol, LDL / Q000097:blood; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000188:drug therapy*; D003925:Diabetic Angiopathies / Q000517:prevention & control*; D004363:Drug Utilization; D005260:Female; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged
chemical_list: D008078:Cholesterol, LDL; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors