Management of dyslipidaemia in patients with type 2 diabetes in Australian primary care.
OBJECTIVE
To examine the frequency of dyslipidaemia and treatment with lipid-lowering drugs in patients with type 2 diabetes managed in Australian primary care.


METHODS
The NEFRON study (National Evaluation of the Frequency of Renal Impairment cO-existing with NIDDM [Non-Insulin Dependent Diabetes Mellitus]) was an incident-driven, cluster-stratified survey of 3893 patients with type 2 diabetes from across Australian primary care between April and September 2005.


METHODS
The most recent fasting lipid levels were compared with therapeutic targets for lipid control and current prescribing guidelines.


RESULTS
64% of patients with type 2 diabetes presenting in primary care received lipid-lowering medication. Despite the widespread use of statins (61%), 75% of patients had a total cholesterol level >or= 4.0 mmol/L, and 47% had a low-density lipoprotein (LDL) cholesterol level >or= 2.5 mmol/L. Few untreated patients met the Australian Pharmaceutical Benefits Scheme (PBS) criteria current at the time for subsidised primary prevention with lipid-lowering agents (4%). However, new PBS subsidy criteria will potentially include 93% of all diabetic patients seeing their general practitioner in primary care.


CONCLUSIONS
Changes in the provision of subsidised therapy for high-risk diabetic patients are long overdue. However, more needs to be done to optimise management strategies, which still fail to achieve treatment targets in many treated patients.
Thomas
Merlin C
MC
Baker Heart Research Institute, Melbourne, VIC. mthomas@baker.edu.au
Nestel
Paul J
PJ
D000368:Aged; D000704:Analysis of Variance; D001315:Australia; D016000:Cluster Analysis; D003625:Data Collection; D003924:Diabetes Mellitus, Type 2 / Q000150:complications* / Q000208:ethnology; D016527:Drug Costs; D004363:Drug Utilization / Q000706:statistics & numerical data; D050171:Dyslipidemias / Q000150:complications / Q000188:drug therapy*; D005260:Female; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000191:economics / Q000627:therapeutic use*; D007356:Insurance, Pharmaceutical Services; D007674:Kidney Diseases / Q000150:complications; D008297:Male; D008875:Middle Aged; D011320:Primary Health Care
D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors