scholarly journals Impact of the 2019 European Guidelines on Diabetes in Clinical Practice: Real and Simulated Analyses of Lipid Goals

2020 ◽  
Vol 7 (1) ◽  
pp. 6
Author(s):  
Walter Masson ◽  
Melina Huerín ◽  
Lorenzo Martin Lobo ◽  
Gerardo Masson ◽  
Graciela Molinero ◽  
...  
Keyword(s):  
High Risk ◽  
Simulation Analysis ◽  
Cross Sectional Study ◽  
Lipid Lowering ◽  
Considerable Proportion ◽  
Diabetic Patients ◽  
Cross Sectional ◽  
Lipid Lowering Drugs ◽  
European Guidelines ◽  
European Society Of Cardiology

Background: Recent European guidelines on diabetes, prediabetes, and cardiovascular disease developed for the European Society of Cardiology (ESC) in collaboration with the European Association for the Study of Diabetes (EASD) significantly changed some concepts on risk stratification, lipid goals, and recommendations for the use of lipid-lowering drugs. The objectives of this work were to describe the lipid-lowering treatment prescribed for patients with diabetes and to determine the percentage of patients that achieved the lipid goals recommended by the 2019 ESC/EASD Guidelines on Diabetes in real and simulated scenarios. Methods: A multicenter, cross-sectional study was performed. Subjects >18 years with type 2 diabetes were included. The recommendations of the 2019 ESC/EASD Guidelines were followed. The real and simulated (ideal setting using adequate doses of statins ± ezetimibe) scenarios were analyzed. Results: Overall, 528 patients were included. In total, 62.5% of patients received statins (17.1% high intensity). Most patients were stratified as “very high risk” (54.2%) or “high risk” (43.4%). Only 13.3% achieved the double lipid goal (LDL-C and non-HDL-C goals according to the risk categories). In the simulation analysis, the proportion of subjects that did not reach the therapeutic objective decreased in all risk strata, although a considerable proportion of subjects persisted outside the target. Conclusion: The difficulty of achieving lipid goals in diabetic patients was considerable when applying the new guidelines. The situation would improve if we optimized treatment, but the prescription of new lipid-lowering drugs could be limited by their high cost.

scholarly journals Hypercholesterolemia, eligibility for lipid-lowering therapy and therapeutic success: population-based study in a Portuguese urban population

2008 ◽  
Vol 159 (6) ◽  
pp. 755-760 ◽  
Author(s):  
Luis Alves ◽  
Ana Azevedo
Keyword(s):  
High Risk ◽  
Venous Blood ◽  
Population Based ◽  
Low Risk ◽  
Lipid Lowering ◽  
Lipid Lowering Therapy ◽  
Therapeutic Success ◽  
Cross Sectional ◽  
Lipid Lowering Drugs ◽  
European Guidelines

BackgroundWe aimed to estimate i) the prevalence of hypercholesterolemia, ii) the proportion of individuals eligible for treatment with lipid-lowering drugs, and iii) therapeutic success, according to the European guidelines on cardiovascular disease prevention in clinical practice.DesignPopulation-based cross-sectional study.MethodsWe surveyed a representative sample of the population of Porto aged 40–65 years. Trained interviewers collected data from 1215 subjects (789 women) on demographic variables, medical history, and medication using structured questionnaires. A fasting venous blood sample was withdrawn. Subjects were considered low risk or high risk as indicated in the European guidelines. Hypercholesterolemia was defined as total cholesterol (TC) ≥5 mmol/l or low-density-cholesterol (LDL-C) ≥3 mmol/l in low-risk subjects, TC ≥4.5 mmol/l or LDL-C ≥2.5 mmol/l in high-risk subjects or being medicated with lipid-lowering drugs. Eligibility for treatment was defined as being high risk and having TC ≥4.5 mmol/l, LDL-C ≥2.5 mmol/l or being on treatment. We defined therapeutic success as having TC <4.5 mmol/l and LDL-C<2.5 mmol/l among medicated subjects.ResultsOverall, 84.9% (95% confidence interval (95% CI): 82.7–86.8) of subjects had hypercholesterolemia and 9.1% (95% CI: 7.5–10.8) were medicated with lipid-lowering drugs. Men were more likely to be eligible for treatment (42.4%) than women (22.4%; OR=2.69, 95% CI 2.07–3.52). Therapeutic success was less frequent in men (46.8%) than in women (66.7%), (OR=0.39, 95% CI 0.17–0.87).ConclusionStrict interpretation of the European guidelines would label 85% of the general population in this age group as hypercholesterolemic and a third eligible for drug treatment. Questions arise regarding medicalization, resource allocation, and sustainability within the healthcare system.

A cross sectional study on assessment of risk of diabetes mellitus using Indian diabetic risk score in a medical college teaching hospital

2020 ◽  
Vol 5 (2) ◽  
pp. 32-40
Author(s):  
Singam Sivasankar Reddy ◽  
Syeda Rahath ◽  
Rakshitha H N ◽  
Godson K Lal ◽  
Swathy S ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
High Risk ◽  
Risk Score ◽  
Hospital Setting ◽  
College Teaching ◽  
Cross Sectional Study ◽  
Diabetic Patients ◽  
Cross Sectional ◽  
Patient Counselling ◽  
Related Quality

The objective of the study was to evaluate the risk of diabetes mellitus in elderlywith age above 20 years in a hospital setting using Indian Diabetes risk score and to provide patient counselling regarding their life style modifications and health related quality of life among participants with high risk of developing diabetes.A total of 125 non diabetic patients were interviewed with a pre designed selfstructured questionnaire (IDRS). Participants were chosen voluntarily and a written consent was obtained before the administration of the questionnaire from individual patients. In our study we observed that out of 125 patients,males 26[59%]and 18[41%] females were at high risk, males 39[58.2%] and 28[41.8%] females were at moderate risk, males 5[35.7%] and 9[64.3%] females were at low risk of developing diabetes mellitus.

ASSOCIATION OF SERUM MAGNESIUM LEVEL WITH RESISTANT HYPERLIPIDEMIA IN DIABETIC AND HYPERTENSIVE PATIENTS

2021 ◽  
pp. 33-35
Author(s):  
Manish Kumar ◽  
Syed Yousuf Faisal ◽  
Sudhir Chandra Jha ◽  
Debarshi Jana
Keyword(s):  
Serum Magnesium ◽  
Cross Sectional Study ◽  
Magnesium Level ◽  
Lipid Lowering ◽  
Diabetic Patients ◽  
Serum Magnesium Level ◽  
Cross Sectional ◽  
Hypertensive Patients ◽  
Present Cross Sectional Study ◽  
Lipid Lowering Agents

Introduction: Both diabetes mellitus and hypertension are aspects of metabolic syndrome. Objectives: The aim of this study was to determine the relationship between serum magnesium level with resistant hyperlipidemia in a group of diabetic and hypertensive patients. Patients And Methods: The present cross- sectional study was carried out on 90 hypertensive and diabetic patients in Medicine Department of DMCH, Laheriasarai, Bihar, (45 hypertensive and 45 diabetic patients). Included patients had high triglyceride levels despite 8 weeks of treatment with lipid-lowering agents. Results: There was an inverse signicant relationship between serum magnesium and triglyceride levels in diabetic patients (P=0.002, r=-0.458), however, this correlation was not signicant in hypertensive patients (P=0.754, r=0.048). Conclusion: This study showed, serum magnesium may affect triglycerides levels in diabetic patients, however, our nding requires further investigation with larger population

scholarly journals Association of serum magnesium level with resistant hyperlipidemia in diabetic and hypertensive patients

2019 ◽  
Vol 9 (1) ◽  
pp. e07-e07
Author(s):  
Pardis Kaveh ◽  
Afsaneh Malekpour Tehrani ◽  
Saeid Mardani
Keyword(s):  
Serum Magnesium ◽  
Cross Sectional Study ◽  
Magnesium Level ◽  
Lipid Lowering ◽  
Diabetic Patients ◽  
Serum Magnesium Level ◽  
Cross Sectional ◽  
Hypertensive Patients ◽  
Present Cross Sectional Study ◽  
Lipid Lowering Agents

Introduction: Both diabetes mellitus and hypertension are aspects of metabolic syndrome. Objectives: The aim of this study was to determine the relationship between serum magnesium level with resistant hyperlipidemia in a group of diabetic and hypertensive patients. Patients and Methods: The present cross-sectional study was carried out on 90 hypertensive and diabetic patients who referred to outpatient university clinic in Shahrekord (45 hypertensive and 45 diabetic patients). Included patients had high triglyceride levels despite 8 weeks of treatment with lipid-lowering agents. Results: There was an inverse significant relationship between serum magnesium and triglyceride levels in diabetic patients (P=0.002, r=-0.458), however, this correlation was not significant in hypertensive patients (P=0.754, r=0.048). Conclusion: This study showed, serum magnesium may affect triglycerides levels in diabetic patients, however, our finding requires further investigation with larger population.

scholarly journals Cross-sectional study of pattern of Dyslipidemia and Prevalence of Atherogenic Diabetic Dyslipidemia in newly detected Diabetic patients

2019 ◽  
Vol 10 (6) ◽  
pp. 45-49
Author(s):  
Vinay Krishnamurthy ◽  
Akhila Rao Kerekoppa ◽  
Prabhakar B
Keyword(s):  
Tertiary Care ◽  
Hdl Cholesterol ◽  
Cross Sectional Study ◽  
Lipid Lowering ◽  
Diabetic Patients ◽  
Lipid Lowering Therapy ◽  
Newly Diagnosed ◽  
Diabetic Dyslipidemia ◽  
Cross Sectional ◽  
Treatment Naïve

Background: India has seen an ever increasing number of diabetic patients and in turn rise in cardiovascular diseases. Many studies have shown diabetic patients to have dyslipidemia, with certain common patterns early in the disease. Aims and Objective: The current study was done to identify pattern of dyslipidemia and prevalence of ADD in treatment naïve diabetic patients. Material and Methods: Fasting lipid profile was analysed in treatment naïve diabetic patients at a tertiary care teaching hospital. Various factors influencing the results were analysed statistically. Results: Prevalence of dyslipidemia was 89.2%, whereasatherogenic diabetic dyslipidemia was seen in 34.2% and raised non-HDL cholesterol in 73.3%. Conclusion: Our study showed a high prevalence of dyslipidemia in newly diagnosed diabetics indicating the importance of screening for dyslipidemia in newly diagnosed cases and implementation of timely lipid lowering therapy to prevent CVD. It also highlights the importance of pattern of dyslipidemia called Atherogenic diabetic dyslipidemia and raised Non-HDL cholesterol in diabetic patients.

Abstract P179: Uncontrolled Cholesterol Levels In Patients With Severe Hypercholesterolemia

Circulation ◽  
2020 ◽  
Vol 141 (Suppl_1) ◽  
Author(s):  
Nicole Groth ◽  
Catherine P Benziger
Keyword(s):  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Heart Association ◽  
Cross Sectional Study ◽  
Lipid Lowering ◽  
Lipid Lowering Therapy ◽  
Cross Sectional ◽  
Lowering Therapy ◽  
Cholesterol Guidelines ◽  
European Society Of Cardiology

Introduction: The 2018 American Heart Association/American College of Cardiology cholesterol guidelines recommends patients who have phenotypic severe hypercholesterolemia (SH), defined as a low-density lipoprotein-cholesterol (LDL-c) > 190 mg/dL, be started on maximally tolerated statin therapy without further risk stratification due to high risk for cardiovascular disease (CVD). SH patients on guideline-directed medical therapy (GDMT) should have 50% reduction in their LDL-c levels, with optimal being < 100 mg/dL for primary prevention and <70 mg/dL for secondary prevention. The 2019 European Society of Cardiology/European Atherosclerosis Society cholesterol guidelines recommend an optimal LDL-c level < 55 mg/dL. Hypothesis: LDL-c levels vary by intensity of medication and are not at target in patients with SH in a large rural healthcare system. Methods: We used an electronic medical record-based SH registry defined by ever having an LDL-c > 190 mg/dL since 01/01/2000 (n=17,925) at Essentia Health (MN, WI, and ND). In this cross-sectional study, patients were excluded if they had: no recent visit within the past 5 years (n=209), <20 or >75 years (n=3,153), listed as being on a statin but intensity was unavailable (n=1,934), or had no recent lab (n=998). Methods: We included 12,283 patients (68.5%)(mean age 59.4 + 10.1 years; 59.5% female) with SH and of these only 22.9% were on a high-intensity statin or proprotein convertase subtilisin/kexin type 9 inhibitor. Of the patients that were not on any lipid-lowering therapy (n=4,971; 40.5%), only 16.8% (n=837) had a statin allergy or intolerance documented. Figure 1 shows the most recent LDL-c levels; <10% of patients in each group had a most-recent LDL-c <70 mg/dL, and 9.4% had an LDL-c <55mg/dL. Conclusions: Most SH patients remain untreated or undertreated with GDMT with recent LDL-c levels above target. More aggressive lipid-lowering therapy in patients with SH is needed to reduce risk of CVD.

scholarly journals Co-prescription patterns of cardiovascular preventive treatments: a cross-sectional study in the Aragon worker’ health study (Spain)

BMJ Open ◽  
2019 ◽  
Vol 9 (4) ◽  
pp. e023571
Author(s):  
Isabel Aguilar-Palacio ◽  
Sara Malo ◽  
MªJesús Lallana ◽  
Cristina Feja ◽  
Juan González ◽  
...  
Keyword(s):  
Preventive Treatment ◽  
Cross Sectional Study ◽  
Frequent Pattern ◽  
Lipid Lowering ◽  
Health Study ◽  
Secondary Outcome ◽  
Sectional Study ◽  
Cross Sectional ◽  
Prescription Patterns ◽  
Lipid Lowering Drugs

ObjectivesTo identify cardiovascular disease (CVD) preventive treatments combinations, among them and with other drugs, and to determine their prevalence in a cohort of Spanish workers.DesignCross-sectional study.SettingAragon Workers’ Health Study (AWHS) cohort in Spain.Participants5577 workers belonging to AWHS cohort. From these subjects, we selected those that had, at least, three prescriptions of the same therapeutic subgroup in 2014 (n=4605).Primary and secondary outcome measuresDrug consumption was obtained from the Aragon Pharmaceutical Consumption Registry (Farmasalud). In order to know treatment utilisation, prevalence analyses were conducted. Frequent item set mining techniques were applied to identify drugs co-prescription patterns. All the results were stratified by sex and age.Results42.3% of men and 18.8% of women in the cohort received, at least, three prescriptions of a CVD preventive treatment in 2014. The most prescribed CVD treatment were antihypertensives (men: 28.2%, women 9.2%). The most frequent association observed among CVD preventive treatment was agents acting on the renin-angiotensin system and lipid-lowering drugs (5.1% of treated subjects). Co-prescription increased with age, especially after 50 years old, both in frequency and number of associations, and was higher in men. Regarding the association between CVD preventive treatments and other drugs, the most frequent pattern observed was lipid-lowering drugs and drugs used for acid related disorders (4.2% of treated subjects).ConclusionsThere is an important number of co-prescription patterns that involve CVD preventive treatments. These patterns increase with age and are more frequent in men. Mining techniques are a useful tool to identify pharmacological patterns that are not evident in the individual clinical practice, in order to improve drug prescription appropriateness.

scholarly journals The Detection of Pre-Diabetic Patients in the Dental Office

2019 ◽  
Author(s):  
Hamda AlMesmar ◽  
Shiamaa AlMashhadani ◽  
Nadia Saleh ◽  
Khaled Farghali
Keyword(s):  
Type 2 Diabetes ◽  
High Risk ◽  
Cross Sectional Study ◽  
Health Condition ◽  
Diabetic Patients ◽  
Cross Sectional ◽  
Dental Office ◽  
Increased Risk ◽  
Sugar Levels

Pre-diabetes is a serious health condition where blood sugar levels are higher than normal, but not high enough yet to be diagnosed as type 2 diabetes. Pre-diabetes puts one at an increased risk of developing type 2 diabetes and heart disease Methodology: A cross-sectional study was carried out on 384 patients aged 20-70 years old, attending the dental clinics to assess the risk for diabetes, using the FINDRISC questionnaire, HbA1c blood test and a periodontal examination. Results: The mean age of participants was 38.90&plusmn;10.74. 32.3% were categorized as no risk, 46.6% low risk, while 19% and 2.1% moderate and high risk of developing diabetes respectively. Tests for serum HbA1c Level showed 46.1 % had normal HbA1c followed by 18.0% and 3.6 % were pre-diabetic and diabetic respectively. 19.3% of participants had periodontal pockets measuring more than 4mm and 15.9% measuring more than 6mm. Conclusion: The study has proven to be useful in identifying patients at high-risk of developing diabetes. Controlling and managing periodontal disease could be a new aspect to include in the standards for diabetes care. Dental settings could be a successful platform to carry out the screening and risk stratification of pre-diabetic patients.

ASSOCIATION OF SERUM LIPID LEVELS WITH DIABETIC RETINOPATHY

2021 ◽  
pp. 28-30
Author(s):  
Tammana Jyothirmai ◽  
P. Beaulah Pushpa ◽  
Maridi Aparna ◽  
Vepa Meenakshi
Keyword(s):  
Diabetic Retinopathy ◽  
Macular Oedema ◽  
Serum Lipids ◽  
Cross Sectional Study ◽  
Lipid Lowering ◽  
Diabetic Patients ◽  
Cross Sectional ◽  
Hard Exudates ◽  
Low Hdl

AIM:To study the association of serum lipids with retinal hard exudates formation, occurrence of clinically signicant macular oedema (CSME) and severity of diabetic retinopathy (DR) in type 2 diabetes METHODS:Type 2 diabetic patients seeking ocular evaluation for diabetic retinopathy were included in this cross-sectional study. They were assessed for presence and severity of diabetic retinopathy (DR), presence of hard exudates, clinically signicant macular oedema (CSME) .Retinal ndings were correlated to serum lipids levels . RESULTS:Totally 100 patients were included, of which 42/100 had diabetic retinopathy of any grade. Retinal hard exudates formation was found to have statistically signicant correlation with the presence of dyslipidemia (p=0.02), increased cholesterol (p=0.002) and LDL levels (p=0.001). The occurrence of CSME showed a statistically signicant correlation with dyslipidemia (p=0.04) and increased LDL levels (p=0.04). Neither occurrence of dyslipidemia nor the increased levels of the various components of serum lipids showed a statistically signicant correlation with high Triglyceride levels or Low HDL-C or increasing severity of diabetic retinopathy CONCLUSION:Elevated serum lipids showed a signicant association with retinal hard exudate formation, CSME in type 2 diabetics. Lipid lowering agents may help in reducing the occurrence of these retinal ndings in diabetic patients.

scholarly journals The Detection of Pre-Diabetic Patients in the Dental Setting

2019 ◽  
pp. 56-63
Author(s):  
Hamda AlMesmar ◽  
Nadia Saleh ◽  
Shiamaa AlMashhadani ◽  
Khaled Farghali
Keyword(s):  
Type 2 Diabetes ◽  
High Risk ◽  
Cross Sectional Study ◽  
Health Condition ◽  
Diabetic Patients ◽  
Cross Sectional ◽  
Dental Clinics ◽  
Increased Risk ◽  
Sugar Levels

Pre-diabetes is a serious health condition where blood sugar levels are higher than normal, but not high enough yet to be diagnosed as type 2 diabetes. Pre-diabetes puts one at an increased risk of developing type 2 diabetes and heart disease. Methodology: A cross-sectional study was carried out on 384 patients aged 20-70 years old, attending the dental clinics to assess the risk for diabetes, using the FINDRISC (Finnish Diabetes Risk Score) questionnaire, HbA1c blood test and a periodontal examination. Results: The mean age of participants was 38.90 ± 10.74. 32.3% were categorized as no risk, 46.6% low risk, while 19% and 2.1% moderate and high risk of developing diabetes respectively. Tests for serum HbA1c Level showed 46.1% had normal HbA1c followed by 18.0% and 3.6% were pre-diabetic and diabetic respectively. 19.3% of participants had periodontal pockets measuring more than 4mm and 15.9% measuring more than 6mm. Conclusion: The study has proven to be useful in identifying patients at high-risk of developing diabetes. Controlling and managing periodontal disease could be a new aspect to include in the standards for diabetes care. Dental settings could be a successful platform to carry out the screening and risk stratification of pre-diabetic patients.

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