Dyslipidemia treatment of patients with diabetes mellitus in a US managed care plan: a retrospective database analysis.
BACKGROUND
To evaluate real-world pharmacologic treatment of mixed dyslipidemia in patients with diabetes mellitus (DM).


METHODS
All commercial health plan members in a large US managed care database with complete lipid panel results (HDL-C, LDL-C, TG) between 1/1/2006 and 12/31/2006 were identified (N = 529,236). DM patients (N = 53,679) with mixed dyslipidemia were defined as having any 2 suboptimal lipid parameters (N = 28,728). Lipid treatment status 6 months pre- and post-index date was determined using pharmacy claims for any lipid therapy.


RESULTS
Post-index, 41.1% of DM patients with 2 abnormal lipid parameters and 45.1% with 3 abnormal lipid parameters did not receive lipid-modifying treatment. Post-index treatment rates were 57.4%, 63.6%, and 66.4% for patients with LDL-C, HDL-C, and TG in the most severe quartiles, respectively. Statin monotherapy was the primary lipid-modifying regimen prescribed (54.8% and 47.8% of patients with any 2 and all 3 lipids not at goal, respectively). Less than 30% of treated patients received combination therapy.


CONCLUSIONS
Over 40% of DM patients with mixed dyslipidemia received no lipid-modifying therapy during the follow-up period. Those who were treated were primarily prescribed statin monotherapy. This study suggests that DM patients are not being treated to ADA-suggested targets.
Toth
Peter P
PP
Sterling Rock Falls Clinic, Sterling, IL, USA. peter.toth@srfc.com
Zarotsky
Victoria
V
Sullivan
Jane M
JM
Laitinen
Dave
D
D000368:Aged; D008076:Cholesterol, HDL / Q000097:blood; D008078:Cholesterol, LDL / Q000097:blood; D003327:Coronary Disease / Q000097:blood / Q000188:drug therapy / Q000209:etiology / Q000517:prevention & control; D016208:Databases, Factual; D048909:Diabetes Complications / Q000097:blood* / Q000188:drug therapy*; D050171:Dyslipidemias / Q000097:blood / Q000150:complications* / Q000188:drug therapy*; D005260:Female; D006801:Humans; D000960:Hypolipidemic Agents / Q000627:therapeutic use*; D008297:Male; D008329:Managed Care Programs; D008875:Middle Aged; D017410:Practice Guidelines as Topic; D012189:Retrospective Studies; D012307:Risk Factors; D014280:Triglycerides / Q000097:blood; D014481:United States
D008076:Cholesterol, HDL; D008078:Cholesterol, LDL; D000960:Hypolipidemic Agents; D014280:Triglycerides