scholarly journals Use of electronic patient data overview with alerts in primary care increases prescribing of lipid-lowering medications in patients with type 2 diabetes

Diabetologia ◽  
2021 ◽  
Author(s):  
Morten H. Charles ◽  
Janus L. Thomsen ◽  
Bo Christensen ◽  
Ryan Pulleyblank ◽  
Line P. Kongstad ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Diabetes Duration ◽  
Lipid Lowering ◽  
Control Group ◽  
Lipid Lowering Drugs ◽  
Lipid Lowering Drug ◽  
Level Of Use ◽  
Lowering Drug ◽  
High Level

Abstract Aims/hypothesis We aimed to assess whether general practices (GPs) using an electronic disease management program (DMP) with population overviews, including alerts when patients failed to receive guideline-recommended prescription medications, increased prescriptions of lipid-lowering drugs for patients with type 2 diabetes with no history of lipid-lowering treatment. Methods This observational study included 165 GPs that reached a high level of use of the DMP in 2012 and a control group of 135 GPs who reached a high level of use in 2013 and, hence, who were less exposed to the DMP throughout 2012. A binary measure for having been prescribed and filled lipid-lowering drugs at any time within a 12-month exposure period was derived for all patients with type 2 diabetes who did not receive a prescription for lipid-lowering drugs in the baseline year prior to the study period (i.e. 2011). Results were derived using ORs from multivariate logistic regression analyses. Subgroup stratification based on age, sex, diabetes duration, deprivation status and Charlson Comorbidity Index (CCI) score was conducted and assessed. Placebo tests were carried out to assess bias from selection to treatment. Results Patients who did not receive a prescription of lipid-lowering drugs in the year prior to being listed with GPs that used the DMP had statistically significant greater odds of receiving a prescription of lipid-lowering medications when compared with individuals who attended control GPs (OR 1.23 [95% CI 1.09, 1.38]). When the analysis period was shifted back by 2 years, no significant differences in lipid-lowering drug prescription between the two groups were found to occur, which indicates that these results were not driven by selection bias. Subgroup analyses showed that the increase in lipid-lowering drug prescriptions was primarily driven by changes among male participants (OR 1.32 [95% CI 1.12, 1.54]), patients aged 60–70 years (OR 1.40 [95% CI 1.13, 1.74]), patients with a diabetes duration of ≤5 years (OR 1.33 [95% CI 1.13, 1.56]), non-deprived patients (OR 1.25 [95% CI 1.08, 1.45]) and patients without comorbidities (CCI score = 0; OR 1.27 [95% CI 1.11, 1.45]). Conclusions/interpretation Access to population overviews using a DMP with alerts of clinical performance measures with regard to adhering to guideline-recommended prescription of medications can increase GP prescriptions of lipid-lowering drugs. Graphical abstract

A large remaining potential in lipid‐lowering drug treatment in the type 2 diabetes population – a Danish nationwide cohort study

2021 ◽  
Author(s):  
Hanan Amadid ◽  
Pernille F. Rønn ◽  
Maria BN. Dunbar ◽  
Jakob S. Knudsen ◽  
Bendix Carstensen ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Cohort Study ◽  
Drug Treatment ◽  
Lipid Lowering ◽  
Lipid Lowering Drug ◽  
Lowering Drug

615-P: A Novel Lipid-Lowering Drug Pemafibrate Enhances Effects of Statins in Serum Lipids in Japanese Patients with Type 2 Diabetes

Diabetes ◽  
2019 ◽  
Vol 68 (Supplement 1) ◽  
pp. 615-P ◽  
Author(s):  
MASATAKA KUSUNOKI ◽  
YUKIE NATSUME ◽  
YOSHIHARU OSHIDA ◽  
TETSURO MIYATA
Keyword(s):  
Type 2 Diabetes ◽  
Serum Lipids ◽  
Japanese Patients ◽  
Lipid Lowering ◽  
Lipid Lowering Drug ◽  
Lowering Drug

137-OR: Trends in Lipid Levels Relative to Lipid-Lowering Drug Use among Danish Type 2 Diabetes Subjects

Diabetes ◽  
2020 ◽  
Vol 69 (Supplement 1) ◽  
pp. 137-OR
Author(s):  
HANAN AMADID ◽  
MARIA BEKKER-NIELSEN DUNBAR ◽  
PERNILLE F. RØNN ◽  
JAKOB S. KNUDSEN ◽  
BENDIX CARSTENSEN ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Drug Use ◽  
Lipid Lowering ◽  
Lipid Levels ◽  
Lipid Lowering Drug ◽  
Lowering Drug

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

2018 ◽  
Vol 16 (4) ◽  
pp. 368-375 ◽  
Author(s):  
Abdullah Shehab ◽  
Khalid Al-Rasadi ◽  
Mohamed Arafah ◽  
Ali T. Al-Hinai ◽  
Wael Al Mahmeed ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Lipid Lowering ◽  
Lipid Lowering Drugs

scholarly journals Age- and Gender-Related Differences in LDL-Cholesterol Management in Outpatients with Type 2 Diabetes Mellitus

2015 ◽  
Vol 2015 ◽  
pp. 1-8 ◽  
Author(s):  
Giuseppina Russo ◽  
Basilio Pintaudi ◽  
Carlo Giorda ◽  
Giuseppe Lucisano ◽  
Antonio Nicolucci ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Serum Levels ◽  
Diabetes Duration ◽  
Lipid Lowering ◽  
Age And Gender ◽  
Chd Risk ◽  
And Gender

Background. Dyslipidemia contribute to the excess of coronary heart disease (CHD) risk observed in women with type 2 diabetes (T2DM). Low density lipoprotein-cholesterol (LDL-C) is the major target for CHD prevention, and T2DM women seem to reach LDL-C targets less frequently than men.Aim. To explore age- and gender-related differences in LDL-C management in a large sample of outpatients with T2DM.Results. Overall, 415.294 patients (45.3% women) from 236 diabetes centers in Italy were included. Women were older and more obese, with longer diabetes duration, higher total-cholesterol, LDL-C, and HDL-C serum levels compared to men (P<0.0001). Lipid profile was monitored in ~75% of subjects, women being monitored less frequently than men, irrespective of age. More women did not reach the LDL-C target as compared to men, particularly in the subgroup treated with lipid-lowering medications. The between-genders gap in reaching LDL-C targets increased with age and diabetes duration, favouring men in all groups.Conclusions. LDL-C management is worst in women with T2DM, who are monitored and reach targets less frequently than T2DM men. Similarly to men, they do not receive medications despite high LDL-C. These gender discrepancies increase with age and diabetes duration, exposing older women to higher CHD risk.

Myopathy Due to Statin/Fibrate Use in the Netherlands

2002 ◽  
Vol 36 (12) ◽  
pp. 1957-1960 ◽  
Author(s):  
Aukje K Mantel-Teeuwisse ◽  
Olaf H Klungel ◽  
Ron MC Herings ◽  
Eugène P van Puijenbroek ◽  
Arijan J Porsius ◽  
...  
Keyword(s):  
Drug Use ◽  
The Netherlands ◽  
Incidence Rates ◽  
Lipid Lowering ◽  
Expected Number ◽  
Lipid Lowering Drugs ◽  
Reductase Inhibitors ◽  
Lipid Lowering Drug ◽  
Using Data ◽  
Lowering Drug

OBJECTIVE: To estimate the number of expected cases of myopathy based on the prevalence of lipid-lowering drug use, and to compare this number with the observed number of cases of myopathy due to lipid-lowering drug use in the Netherlands. METHODS: Prevalence of lipid-lowering drug use in 1998 was estimated by using data from the PHARMO record linkage system comprising pharmacy records linked to hospital admission data. The expected number of cases of myopathy was calculated by multiplying the total number of person-years of lipid-lowering drug use by the excess incidence rates of myopathy due to those drugs as reported in the literature. The observed number of cases was obtained from PHARMO and the Dutch Pharmacovigilance Foundation Lareb. RESULTS: Based on the estimated prevalence of lipid-lowering drug use in the Netherlands in 1998 (n = 520 800), we expected 60 cases of idiopathic myopathy due to hydroxymethylglutaryl coenzyme A reductase inhibitors (statins) or fibric acid derivatives (fibrates). This low number was confirmed by data from PHARMO (n = 11; none of these were related to current use of lipid-lowering drugs) and Lareb (n = 43). CONCLUSIONS: The expected number of statin- or fibrate-related idiopathic myopathy is low and observed numbers are even lower in the Netherlands. This should, therefore, not compromise continued use of lipid-lowering drugs.

scholarly journals Supplementation with EPA or fish oil for 11 months lowers circulating lipids, but does not delay the onset of diabetes in UC Davis-type 2 diabetes mellitus rats

2010 ◽  
Vol 104 (11) ◽  
pp. 1628-1634 ◽  
Author(s):  
Bethany P. Cummings ◽  
Kimber L. Stanhope ◽  
James L. Graham ◽  
Steven C. Griffen ◽  
Peter J. Havel
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Body Weight ◽  
Fish Oil ◽  
Lipid Lowering ◽  
Control Group ◽  
Fasting Plasma ◽  
Fish Oil Supplementation

EPA or fish oil supplementation has been suggested as treatments for the prevention of type 2 diabetes mellitus (T2DM) due to their lipid-lowering and potential insulin-sensitising effects. We investigated the effects of supplementation with EPA (1 g/kg body weight per d) or fish oil (3 g/kg body weight per d) on the age of onset of T2DM and circulating glucose, insulin, lipids, leptin and adiponectin in UC Davis (UCD)-T2DM rats. Animals were divided into three groups starting at 1 month of age: control, EPA and fish oil. All the animals were followed until diabetes onset or for up to 12 months of age. Monthly fasting blood samples were collected for the measurement of glucose, lipids, hormones and C-reactive protein (CRP). Neither EPA nor fish oil delayed the onset of T2DM or altered fasting plasma glucose, insulin, CRP, adiponectin or leptin concentrations. The groups did not differ in energy intake or body weight. Fish oil treatment lowered fasting plasma TAG concentrations by 39 (sd 7) % (P < 0·001) and EPA lowered fasting plasma NEFA concentrations by 23 (sd 5) % (P < 0·05) at 4 months of age compared with the control group. EPA and fish oil lowered fasting plasma cholesterol concentrations at 4 months of age by 19 (sd 4) and 22 (sd 4) % compared with the control group, respectively (both P < 0·01). In conclusion, EPA and fish oil supplementation lowers circulating lipid concentrations, but does not delay the onset of T2DM in UCD-T2DM rats.

Abstract P047: Improved Clinical Outcomes Associated with Dual-Goal (HbA1c and LDL-C) Achievement in Newly Diagnosed Type 2 Diabetes Mellitus

Circulation ◽  
2013 ◽  
Vol 127 (suppl_12) ◽  
Author(s):  
Lizheng Shi ◽  
Xin Ye ◽  
Mei Lu ◽  
Eric Q Wu ◽  
Hari Sharma ◽  
...  
Keyword(s):  
Index Date ◽  
Microvascular Complications ◽  
Goal Achievement ◽  
Lipid Lowering ◽  
Newly Diagnosed ◽  
Factors Associated ◽  
Lipid Lowering Drug ◽  
Clinical Benefits ◽  
Lowering Drug

Background: Compared with studies on achieving a single goal of either glycated hemoglobin (HbA1c) or low-density lipoprotein cholesterol (LDL-C) in type 2 diabetes mellitus (T2DM), the clinical benefits of dual-goal achievement (LDL-C<100 mg/dl and HbA1c<7%) are not well documented. This study investigated factors and clinical benefits associated with dual-goal achievement in newly diagnosed T2DM patients. Methods: Newly diagnosed adult T2DM patients with ≥2 measures of LDL-C and HbA1c were identified in the Veterans Integrated Services Network 16 data warehouse (01/2004-06/2010). A logistic regression model was used to identify factors associated with dual-goal achievement during 7-12 months following the index date (first HbA1c recorded within three months of the first T2DM diagnosis). Factors included demographics and 0-6 month dual-goal achievement, as well as diabetes-related comorbidities, medications, surgeries, and healthcare utilization, all measured during the 1-year period surrounding the index date. Multivariate Cox proportional hazards models were used to assess the association between time-varying goal achievement status and post-index date clinical outcomes, including microvascular complications (retinopathy, nephropathy, and neuropathy), cardiovascular-related complications (cardiovascular death, stroke, or myocardial infarction) and acute coronary syndromes (ACS). Results: A total of 16,829 T2DM patients were included in the study. Factors associated with an increased likelihood of dual-goal achievement include older age, higher Charlson Comorbidity Index (CCI), prior dual-goal achievement, diagnosis of ketoacidosis or hypersmolarity, and lipid-lowering drug use. Conversely, patients with prior diagnoses of retinopathy, neuropathy, and congestive heart failure, as well as prior insulin use were less likely to achieve both goals. Compared with failure to achieve either goal, achieving only LDL-C goal was associated with a lower risk of cardiovascular-related complications (HR:0.76; 95% CI:0.71-0.81) and ACS (HR:0.76; 95% CI:0.67-0.86), while achieving only HbA1C goal was associated with a lower risk of microvascular complications (HR:0.73; 95% CI:0.71-0.74), cardiovascular-related complications (HR:0.80; 95% CI:0.74-0.87) and ACS (HR:0.66; 95% CI:0.60-0.72). Dual-goal achievement was associated with additional reduction in risk of microvascular complications (HR: 0.69; 95% CI: 0.63-0.76) vs. only LDL-C goal achievement, but had similar risk to achieving HbA1c goal alone. Conclusions: Older age, higher CCI, prior dual-goal achievement, and lipid-lowering drug use were associated with a greater likelihood of dual-goal achievement. Dual-goal achievement in newly diagnosed T2DM patients is associated with decreased risks of microvascular complications than those with only LDL-C goal achievement.

scholarly journals Clinician prescription of lipid-lowering drugs and achievement of treatment goals in patients with newly diagnosed type 2 diabetes mellitus

2021 ◽  
Vol 9 (1) ◽  
pp. e001891
Author(s):  
Ana Cristina García-Ulloa ◽  
Claudia Lechuga-Fonseca ◽  
Fabiola Mabel Del Razo-Olvera ◽  
Carlos Alberto Aguilar-Salinas ◽  
Karla Ivette Galaviz ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Myocardial Infarct ◽  
Combined Treatment ◽  
Real Life ◽  
Lipid Lowering ◽  
Moderate Intensity ◽  
Lipid Lowering Drugs

IntroductionLipid control is essential in type 2 diabetes mellitus (T2DM). The aim of this study is to investigate factors associated with lipid therapy adherence and achievement of goals in real-life setting among patients with recently diagnosed T2DM.Research design and methodsThis is a longitudinal analysis in a center of comprehensive care for patients with diabetes. We include patients with T2DM, <5 years of diagnosis, without disabling complications (eg, amputation, myocardial infarct, stroke, proliferative retinopathy, glomerular filtration rate <60 mL/min/m2) and completed 2-year follow-up. The comprehensive diabetes care model includes 9 interventions in 4 initial visits and annual evaluations. Endocrinologists follow the clinic’s guideline and adapt therapy to reach risk-based treatment goal. The main outcome measures were the proportion of patients meeting low-density lipoprotein cholesterol (c-LDL) (<100 mg/dL) and triglycerides (<150 mg/dL) and proportion of patients taking statin, fibrate or combination at baseline, 3 months and annual evaluations.ResultsWe included 288 consecutive patients (54±9 years, 53.8% women), time since T2DM diagnosis 1 (0–5) year. Baseline, 10.8% patients were receiving statin therapy (46.5% moderate-intensity therapy and 4.6% high-intensity therapy), 8.3% fibrates and 4.2% combined treatment. The proportion of patients with combined treatment increased to 41.6% at 3 months, decreased to 20.8% at 1 year and increased to 38.9% at 2 years of evaluation. Patients receiving treatment met LDL and triglycerides goals at 3 months (17% vs 59.7%, relative ratio (RR)=0.89, 95% CI 0.71 to 1.12), at 1 year (17% vs 26.7%, RR=0.62, 95% CI 0.41 to 0.95) and at 2 years (17% vs 29.9%, RR=0.63, 95% CI 0.43 to 0.93). Main reasons for medication suspension: patient considered treatment was not important (37.5%) and other physician suspended treatment (31.3%).Conclusion88.2% of patients with T2DM required lipid-lowering drugs. Education for patients and physicians is critical to achieve and maintain diabetes goals.Trial registration numberNCT02836808.

scholarly journals Effect of the Islamic Self-care Nutrition Method on the Lipid Profile of Patients with Type 2 Diabetes: A Randomized Clinical Controlled Trial

2020 ◽  
Vol 8 (B) ◽  
pp. 161-167
Author(s):  
Manizheh Zakizad Abkenar ◽  
Fazlollah Ghofranipour ◽  
Zahra Kashi ◽  
Ali Montazeri
Keyword(s):  
Type 2 Diabetes ◽  
Lipid Profile ◽  
Controlled Trial ◽  
Self Care ◽  
Analysis Of Covariance ◽  
Lipid Lowering ◽  
Control Group ◽  
And Control ◽  
Experimental Group

BACKGROUND: Dyslipidemia is one of the main risk factors of cardiovascular disease in people with diabetes. The principle of diabetes prevention and control is based on patient self-care and education. The Islamic self-care nutrition method is a common and successful way to modify behavior in Islamic ethics and mysticism. AIM: The study aimed to determine the effect of the Islamic self-care nutrition method on the lipid profile of patients with type 2 diabetes. MATERIALS AND METHODS: The present clinical trial was conducted in 2014 on 98 middle-aged patients with type 2 diabetes referred to the Diabetes Center of the Mazandaran University of Medical Sciences, Sari, Iran, who were randomly allocated into two groups of experimental and control. Lipid indices were measured before intervention, and the same education about diabetic healthy diet was provided in both groups. In addition, in the experimental group, Islamic teachings and the Islamic self-care method of nutrition were taught with the intention of pleasing God. Data were analyzed with SPSS 22 software using independent and paired t-test, Chi-square, Fisher’s exact, and analysis of covariance (ANCOVA). RESULTS: After adjusting for the effect of confounding variables with ANCOVA, significant improvement was observed in triglycerides and low-density lipoprotein indices in the experimental group after intervention compared to the control group. Two-proportion z-test results showed a significant increase in the use of lipid-lowering drugs in the control group compared with the experimental group after intervention. CONCLUSION: The Islamic self-care nutrition method could be used to control chronic diseases such as type 2 diabetes affected by behavioral factors.

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