Objective: Identify the extent of statin use for primary prevention of macrovascular complications, the extent of statin or gemfibrozil use for the secondary prevention of cardiovascular morbidity and mortality, and the statin doses used in patients with type 2 diabetes and other
cardiovascular risk factors.Design: Retrospective chart review.Setting: Three adult day health care centers in Brooklyn and Queens, New York.Patients: Patients with a diagnosis of type 2 diabetes and either a history of coronary artery disease or at least one
other significant cardiovascular risk factor as defined by the American College of Physicians guidelines (i.e., age greater than 55 years, hypertension, left-ventricular hypertrophy, previous cerebrovascular disease, or peripheral arterial disease).Main Outcome Measures: Percentage
of patients prescribed a statin for primary prevention of macrovascular complications of type 2 diabetes, percentage of patients prescribed a statin or gemfibrozil for secondary prevention of cardiovascular mortality and morbidity, and the percentage of patients on at least moderate doses
of statins.Results: Ninety-three patients were evaluated—51 in the primary-prevention group and 42 in the secondary-prevention group. In the primary-prevention group, 33 (64.7%) patients were prescribed a statin, while in the secondary-prevention group, 26 (61.9%) patients
were on statins, a nonsignificant difference (P = 0.8308). No patients were prescribed gemfibrozil. Of all patients prescribed statins, 63.2% were at least on moderate doses.Conclusion: This study demonstrates suboptimal treatment with statins in patients with type 2 diabetes
and cardiovascular risk factors.
Lessons Learned From the HEALTHY Primary Prevention Trial of Risk Factors for Type 2 Diabetes in Middle School Youth
