Lipid management strategies for diabetic patients align with an evidence-based guideline.

IF 2.5 4区医学 Q3 PHARMACOLOGY & PHARMACY DARU Journal of Pharmaceutical Sciences Pub Date : 2024-09-06 DOI:10.1007/s40199-024-00534-x

Mona Kargar, Noushid Zare, Aarefeh Jafarzadeh Kohneloo, Fatemeh Afra, Elham Hadidi, Kheirollah Gholami

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Abstract

Background: Diabetes mellitus (DM) increases the risk of cardiovascular diseases (CVD) significantly. Statins are recommended for all diabetic patients aged ≥ 40 years to alleviate this risk.

Objectives: This study aimed to determine the status of the implementation of the recommendations of lipid management strategies for diabetic patients.

Methods: In this cross-sectional study, 500 patients with DM, aged ≥ 40 referring to a public pharmacy with at least one diabetic medication in their prescription, were enrolled. Patients' demographics, lipid panel data, medications, personal and family history of atherosclerotic cardiovascular disease (ASCVD), and risk factors for ASCVD were documented. The appropriateness of stain dosing intensity was judged based on the American Diabetes Association (ADA) guideline.

Results: The mean ± SD of the age of patients was 61.39 ± 10.49 years. Among patients, 238 (47.6) were men. More than half of the patients were subject to receiving primary prevention (59.8%, n = 299). For 80.8% (n = 404) of patients, a statin, most frequently atorvastatin (61.8%), was prescribed. The appropriate statin dose based on the guideline for 470 patients (94%), was high-intensity statin. In 70.6% (n = 353) of patients, lipid management was not in accordance with the guideline. Patients with ASCVD were more likely to receive the statins and the appropriate doses compared to patients without ASCVD (p-value < 0.001).

Conclusion: Despite a relatively high percentage of patients who received statins, the lipid management in most patients was not in accordance with the guideline. The profound problem was the suboptimal dosage of statins. Investigating the reasons and barriers of the appropriate management can be helpful. Additionally, since patients without ASCVD who should receive statins for primary prevention were significantly less likely to receive statins and evidence-based doses, more attention is needed for this population.

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糖尿病患者的血脂管理策略符合循证指南。

背景：糖尿病（DM）会显著增加心血管疾病（CVD）的风险。建议所有年龄≥40 岁的糖尿病患者服用他汀类药物来降低这一风险：本研究旨在确定糖尿病患者血脂管理策略建议的实施情况：在这项横断面研究中，500 名年龄≥ 40 岁的糖尿病患者被纳入研究范围，他们在公共药房就诊，处方中至少有一种糖尿病药物。研究记录了患者的人口统计学特征、血脂组合数据、用药情况、个人和家族动脉粥样硬化性心血管疾病（ASCVD）病史以及 ASCVD 的危险因素。根据美国糖尿病协会（ADA）指南判断染色剂剂量强度是否合适：患者的平均年龄（61.39±10.49）岁。238 名患者（47.6%）为男性。一半以上的患者接受初级预防（59.8%，n = 299）。80.8%的患者（n = 404）处方了他汀类药物，最常见的是阿托伐他汀（61.8%）。根据指南，470 名患者（94%）的他汀类药物适当剂量为高强度他汀类药物。70.6%（353 人）的患者血脂管理不符合指南要求。与无 ASCVD 的患者相比，有 ASCVD 的患者更有可能接受他汀类药物和适当剂量的治疗（P 值结论）：尽管接受他汀类药物治疗的患者比例相对较高，但大多数患者的血脂管理并不符合指南要求。最严重的问题是他汀类药物的剂量不够理想。调查适当管理的原因和障碍会有所帮助。此外，由于应接受他汀类药物进行一级预防的无 ASCVD 患者接受他汀类药物和循证剂量的可能性明显较低，因此需要对这一人群给予更多关注。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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DARU Journal of Pharmaceutical Sciences PHARMACOLOGY & PHARMACY-

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期刊介绍： DARU Journal of Pharmaceutical Sciences is a peer-reviewed journal published on behalf of Tehran University of Medical Sciences. The journal encompasses all fields of the pharmaceutical sciences and presents timely research on all areas of drug conception, design, manufacture, classification and assessment. The term DARU is derived from the Persian name meaning drug or medicine. This journal is a unique platform to improve the knowledge of researchers and scientists by publishing novel articles including basic and clinical investigations from members of the global scientific community in the forms of original articles, systematic or narrative reviews, meta-analyses, letters, and short communications.