HANDE ERMAN
Southern Clinics of Istanbul Eurasia - 2022;33(3):262-269
INTRODUCTION: Atherosclerotic cardiovascular disease (ASCVD) is a major cause of morbidity and mortality worldwide. The aim of the study was to reveal the success rates of glycemic control, serum low-density lipoprotein cholesterol (LDL-C), serum triglyceride (TG), and non-high density lipoprotein cholesterol (non-HDL-C) targets in type 2 diabetes mellitus (T2DM) patients according to recent guidelines. METHODS: The study was a retrospective observational study of 389 previously diagnosed T2DM patients (217 women and 172 men) in an outpatient diabetes clinic. Demographic characteristics, comorbidities, medications, and laboratory measurements were recorded from the electronic system. ASCVD risks and target rates for LDL-C, TG, non-HDL-C, and HbA1c were evaluated according to 2019 European Society of Cardiology (ESC)/European Atherosclerosis Society (EAS) guidelines. Results: In total subjects, mean values of age, BMI, and HbA1c were 57.95±9.53 years, 31.45±5.36 kg/m2, and 7.83±1.35%, respectively. Of the total cases, 22.6% had moderate, 12.6% had high, and 64.8% had very high ASCVD risks. The percentages of patients with target LDC C, TG, and Non-HDL-c values were low in overall patient group (7.8%, 45.5%, and 8.9%, respectively). Coronary artery disease was found more frequently in men with T2DM than in women (p=0.001). Diabetic polyneuropathy was seen more prominent in patients with statin treatment (p<0.001). Although lower LDL-C was seen in patients under statin treatment (p<0.001), the percentage of patients with target LDL-C was similar in both groups (p=0.239). In this study 8.9% of total T2DM patients were on target for Non-HDL-C values. It is noteworthy that, patients using statins have lower Non-HDL-C and better target rates (p<0.001 and p=0.029). In patients with >7% HbA1c, LDL-C target success rates were lower (p=0.028), but Non-HDL-C target success rates were higher (p=0.039). DISCUSSION AND CONCLUSION: In this pilot observation, the rate of achievement of the lipid targets recommended by 2019 ESC/EAS was low. More attention is needed to achieve success rates of lipid parameters and manage the risk of ASCVD in T2DM patients.
