title: Factors associated with treatment success in veterans with diabetes and hyperlipidemia: a retrospective study.
abstract: The purpose of this study is to identify factors related to achieving a LDL <100 mg/dL.
  
  
  
  Data from a recent randomized control trial of nurse case management versus usual care conducted at the Minneapolis Veterans Affairs Health Care System were analyzed. The trial consisted of 556 veterans with diabetes mellitus (DM) and at least 1 of the following: blood pressure (BP) >140/90 mmHg, and/or glycated hemoglobin (A1C) >9.0%, and/or LDL >100 mg/dL. The current analysis is focused on 275 patients in either treatment group who, at baseline, had LDL >100 mg/dL. Baseline characteristics and variables obtained during the trial of the 95 patients who reached goal LDL were compared to the 180 who did not.
  
  
  
  Patients who reached goal LDL had higher rates of preexisting coronary artery disease (CAD), cerebrovascular accident (CVA), congestive heart failure (CHF), and HMG-coenzyme A reductase inhibitor (statin) use. After adjustment for baseline LDL, preexisting CAD, CVA, and CHF increased the odds of patients achieving a goal LDL <100 mg/dL. This is possibly secondary to the increased prevalence of these conditions in patients with DM. These patients also likely had multiple other providers involved in their care promoting attainment of lower LDL. Baseline statin usage was not related to achieving a LDL<100 mg/dL, however, patients declining to take a statin at any time during the trial had decreased odds of reaching goal LDL. Patients with preexisting neuropathy were also less likely to reach goal LDL.
  
  
  
  Preexisting CAD, CVA, or CHF all increased the odds of patients achieving a goal LDL <100 mg/dL while declining statin therapy and preexisting neuropathy reduced the odds.
authors.affiliation: Minneapolis Veterans Affairs Health Care System, Minneapolis, Minnesota (Dr Tressler, Dr Greer, Dr Rector, Dr Ishani, Dr Ercan-Fang)|Department of Medicine, University of Minnesota, Minneapolis, Minnesota (Dr Tressler, Dr Greer, Dr Rector, Dr Ishani, Dr Ercan-Fang)
authors.forename: Michael C
authors.initials: MC
authors.lastname: Tressler
authors.affiliation: Minneapolis Veterans Affairs Health Care System, Minneapolis, Minnesota (Dr Tressler, Dr Greer, Dr Rector, Dr Ishani, Dr Ercan-Fang)|Department of Medicine, University of Minnesota, Minneapolis, Minnesota (Dr Tressler, Dr Greer, Dr Rector, Dr Ishani, Dr Ercan-Fang)
authors.forename: Nancy
authors.initials: N
authors.lastname: Greer
authors.affiliation: Minneapolis Veterans Affairs Health Care System, Minneapolis, Minnesota (Dr Tressler, Dr Greer, Dr Rector, Dr Ishani, Dr Ercan-Fang)|Department of Medicine, University of Minnesota, Minneapolis, Minnesota (Dr Tressler, Dr Greer, Dr Rector, Dr Ishani, Dr Ercan-Fang)
authors.forename: Thomas S
authors.initials: TS
authors.lastname: Rector
authors.affiliation: Minneapolis Veterans Affairs Health Care System, Minneapolis, Minnesota (Dr Tressler, Dr Greer, Dr Rector, Dr Ishani, Dr Ercan-Fang)|Department of Medicine, University of Minnesota, Minneapolis, Minnesota (Dr Tressler, Dr Greer, Dr Rector, Dr Ishani, Dr Ercan-Fang)
authors.forename: Areef
authors.initials: A
authors.lastname: Ishani
authors.affiliation: Minneapolis Veterans Affairs Health Care System, Minneapolis, Minnesota (Dr Tressler, Dr Greer, Dr Rector, Dr Ishani, Dr Ercan-Fang)|Department of Medicine, University of Minnesota, Minneapolis, Minnesota (Dr Tressler, Dr Greer, Dr Rector, Dr Ishani, Dr Ercan-Fang)
authors.forename: Nacide
authors.initials: N
authors.lastname: Ercan-Fang
mesh_terms: D000368:Aged; D001794:Blood Pressure; D002318:Cardiovascular Diseases / Q000097:blood / Q000188:drug therapy / Q000453:epidemiology*; D008078:Cholesterol, LDL / Q000097:blood*; D015897:Comorbidity; D003920:Diabetes Mellitus / Q000097:blood / Q000188:drug therapy / Q000453:epidemiology*; D003925:Diabetic Angiopathies / Q000097:blood / Q000188:drug therapy / Q000453:epidemiology*; D005260:Female; D005500:Follow-Up Studies; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D006949:Hyperlipidemias / Q000097:blood / Q000188:drug therapy / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D008910:Minnesota / Q000453:epidemiology; D009042:Motivation; D015995:Prevalence; D012189:Retrospective Studies; D012648:Self Care; D016896:Treatment Outcome; D014728:Veterans
chemical_list: D008078:Cholesterol, LDL; D006442:Glycated Hemoglobin; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; C517652:hemoglobin A1c protein, human