A survey on intensity of statin therapy among diabetes mellitus patients in secondary care practice
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ORIGINAL ARTICLE
A survey on intensity of statin therapy among diabetes mellitus patients in secondary care practice K. Indira Adiga 1
&
R. Padmakumar 2
&
U. Shashikiran 3
Received: 16 October 2019 / Accepted: 21 April 2020 # Research Society for Study of Diabetes in India 2020
Abstract Objectives To assess the prevalence of statin usage, intensity of statin therapy, and serum LDL cholesterol levels achieved in clinical diabetes mellitus population to analyze whether the recommendations of American College of Cardiology/American Heart Association’s cholesterol guidelines 2013 (ACC/AHA cholesterol guidelines 2013) are achieved in them. Methods Fasting lipid profile values, prevalence of statin usage, and intensity of statin therapy among 306 diabetes mellitus patients in the age group of 40 to 75 years, visiting the medicine department of a secondary care hospital, were noted. Results were analyzed as per the ACC/AHA cholesterol guidelines 2013 using Microsoft excel 2016. Results Out of 294 diabetes mellitus patients who qualified for statin therapy, only 68% (199) are on statins. In this group of patients, 22% (44) are on low-intensity, 77% on moderate-intensity, and 1% (3) are on high-intensity statin therapy. When the serum LDL cholesterol levels of the diabetic patients were analyzed, only 21% (64) of them could achieve the level of < 70 mg/dl, below which the risk of developing cardiovascular disease is low. Conclusions Dyslipidemia, a risk factor for the development and progression of atherosclerosis among diabetes mellitus patients, is not being treated in secondary care practice as per the ACC/AHA cholesterol guidelines of 2013. Initiating moderate-intensity statin therapy among non-statin users and shifting patients on low-intensity to moderate-intensity statin therapy would help these patients in achieving the desired serum LDL cholesterol level of < 70 mg/dl. Keywords ACC/AHA cholesterol guidelines 2013 . Diabetes mellitus . Intensity of statin therapy . Serum LDL cholesterol level
Introduction Diabetes mellitus is considered as a well-established independent risk factor for cardiovascular diseases (CVD). Risk of death from stroke and heart disease among diabetic patients is 2 to 4 times higher when compared with non-diabetic individuals [1]. Hyperglycemia alone cannot explain the higher cardiovascular risk in diabetes mellitus patients, simply because aggressive glycemic control need not necessarily lead to decrease in the
* K. Indira Adiga [email protected] 1
Biochemistry, Melaka Manipal Medical College, Manipal Academy of Higher Education, Manipal, India
2
Cardiology, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, India
3
Medicine, Melaka Manipal Medical College, Manipal Academy of Higher Education, Manipal, India
incidence of cardiovascular events [2]. Therefore, in order to manage vascular complications associated with diabetes, an approach is to address additional risk factors that lead to the development as well as progression of atherosclerosis rather
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