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The Management of Dyslipidaemia in Patients with Type 2 Diabetes Mellitus Receiving Lipid-Lowering Drugs: A Sub-Analysis of the CEPHEUS Findings

Author(s):

Abdullah Shehab*, Khalid Al-Rasadi, Mohamed Arafah, Ali T. Al-Hinai, Wael Al Mahmeed, Akshaya Srikanth Bhagavathula, Omer Al Tamimi, Shorook Al Herz, Faisal Al Anazi, Khalid Al Nemer, Othman Metwally, Akram Alkhadra, Mohammed Fakhry, Hossam Elghetany, Abdel Razak Medani, Afzal Hussein Yusufali, Obaid Al Jassim, Omar Al Hallaq, Fahad Omar Ahmed S. Baslaib, Mahmoud Alawadhi, Haitham Amin, Khamis Al-Hashmi and Abderrahim Oulhaj   Pages 1 - 8 ( 8 )

Abstract:


Background: Dyslipidaemia is a risk factor for macrovascular complications in patients with type 2 diabetes mellitus (T2DM). Our aim was to assess the use of lipid lowering drugs (LLDs) in patients with T2DM and co-existing dyslipidaemia. Method: A multicentre, non-interventional survey conducted in 6 Middle Eastern countries (Bahrain, Oman, Qatar, United Arab Emirates, Kingdom of Saudi Arabia and Kuwait). Patients with T2DM (n = 3338) who received LLD treatment for ≥3 months with no dose change for ≥6 weeks were enrolled. Results: The mean age (SD) of T2DM patients was 56.6 ±10.6 years; the majority (99%) were on statin monotherapy. Only 48% of these patients achieved their low density lipoprotein cholesterol (LDL-C) goal and 67.7% of the patients had a high cardiovascular disease (CVD) risk according to the National Cholesterol Education Program (NCEP) Adult Treatment Panel (ATP) III guidelines. Of those who achieved LDL-C goals (n=1589), approximately one-third were at very high CVD risk and the patients who had received statin monotherapy showed the highest proportion in LDL-C goal attainment, followed by those treated with fibrate monotherapy. In a multivariate logistic regression model, taking drugs daily (odds ratio, OR: 1.64, 95% CI 1.25, 2.15) and older age (OR: 1.09, 95% CI 1.01, 1.18) were significantly associated with better odds of attaining LDL-C target. In contrast, patients with higher levels of ApoA1 (OR: 0.73, 95% CI [0.67,0.79 ]), Metabolic Syndrome (OR: 0.64, 95% CI [0.53, 0.76]), higher CV risk (OR: 0.33, 95% CI 0.27, 0.41), those who forgot to take their medication (OR: 0.74, 95% CI 0.62,0.88) and those who stopped taking medication when cholesterol became normal (OR: 0.67, 95% CI 0.55,0.82) were significantly associated with lower odds of attaining LDL-C target. Conclusion: The results of this study highlight the suboptimal management of dyslipidaemia in T2DM patients at high and very high risk of CVD.

Keywords:

Centralized Pan-Middle East Survey (CEPHEUS), Dyslipidaemia, Lipid-lowering drugs (LLDs), Low-density lipoprotein cholesterol (LDL-C), Type 2 Diabetes Mellitus (T2DM), Middle East, Cardiovascular disease (CVD).

Affiliation:

Department of Internal Medicine, College of Medicine and Health Sciences-CMHS, United Arab Emirates University, Sultan Qaboos University Hospital, Muscat, King Khalid University Hospital, Riyadh, Sultan Qaboos University, College of Medicine & Health Sciences, Muscat, Sheikh Khalifa Medical City, Abu Dhabi, University of Gondar-College of Medicine and Health Sciences, Gondar, Hamad Medical Corporation, Doha, King Fahad National Guard Hospital, Riyadh, Ministry of Health, Riyadh, Security Force Hospital, Riyadh, King Fahad General Hospital, Jeddah, King Fahad Hospital of the University, Khobar, Soliman Fakieh Hospital, Jeddah, Soliman Fakieh Hospital, Jeddah, Dubai Hospital, Dubai, American Hospital, Dubai, Dubai Hospital, Dubai, American Hospital, Dubai, Rashid Hospital, Dubai, Al Amiri Hospital, Kuwait City, Bahrain Defense Force Hospital, Riffa, King Khalid University Hospital, Riyadh, Institute of Public Health, College of Medicine and Health Sciences, UAE University, Al Ain



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