Lowering Cholesterol in Patients With Diabetes and Dyslipidemia

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Parris ES, Lawrence DB, Mohn LA, et al.: Adherence to Statin Therapy and LDL Cholesterol Goal Attainment by Patients With Diabetes and Dyslipidemia. Diabetes Care 28:595-599, 2005.

What is the problem and what is known about it so far?

People with diabetes are much more likely to get cardiovascular disease (heart and blood vessel disease) than people without diabetes. Having high cholesterol (fat in the blood) also leads to heart and blood vessel disease.

There are treatments available that can lower cholesterol, but many patients do not stay on their medication.

Why did the researchers do this particular study?

The researchers wanted to see how well patients with diabetes and high LDL cholesterol (the “bad” cholesterol) followed their treatment programs. The researchers hoped the study would help them create better programs for preventing heart attacks and strokes in patients with high LDL cholesterol and diabetes.

Who was studied?

A total of 317 men and 336 women who had diabetes and high LDL cholesterol.

How was the study done?

The researchers looked at the patients' medical records over 2 years to see how much the patients had lowered their LDL cholesterol.

Using pharmacy records, researchers also looked at how long patients took to refill their prescriptions for LDL cholesterol-lowering drugs. The researchers could then determine whether the patients were sticking to their treatment programs.

What did the researchers find?

Researchers found that patients who stuck to their treatment programs had lower LDL cholesterol levels. Forty-four percent of the patients lowered their cholesterol to healthy levels.

Patients who did not lower their cholesterol to healthy levels did not follow their treatment program as well as those who did.

What were the limitations of the study?

There are many reasons why people don't stay on a treatment program, but this study could not identify those reasons. This study did not include information on the patients' educational levels, ethnic backgrounds, income level, and other things that may affect their treatment.

This study was not very long, and over time, patients tend to follow treatment programs less closely.

What are the implications of the study?

When patients fail to lower their LDL cholesterol to a healthy level, doctors should look at whether the patients are taking their medications. Doctors must stress the importance of lowering LDL cholesterol levels, and how high LDL cholesterol can lead to a heart attack or stroke. Sticking to a treatment program and lowering LDL cholesterol can help prevent a heart attack or stroke.

FOR MORE INFORMATION

Diabetic Dyslipidemia (PDF)

Oral Antihyperglycemic Medication Nonadherence and Subsequent Hospitalization Among Individuals With Type 2 Diabetes, by D.T. Lau and D.P. Nau. Diabetes Care 27:2149–2153, 2004

Back to Basics: Cholesterol, by S.R. Roberts Diabetes Forecast , March 2005, p. 33-35