Lipid control in patients with and without type 2 Diabetes Mellitus (T2DM). The experience of a special unit of a second grade hospital

Stamatis S Papadatos, Adamantios Bourdakis



Introduction: The prevalence of T2DM is worryingly increasing, the current understanding that T2DM is a metabolic disorder rather than a single disease makes the management of diabetics challenging. In parallel, dyslipidemia is a fundamental risk factor for atherosclerotic cardiovascular disease (ASCVD) that can be reversible under pharmaceutical and hygienodietetic measures. Given that the risk of ASCVD is already elevated for patients with T2DM, the lipid management is of great importance to them.
Patients and Methods: Dyslipidemic patients (n=114) with T2DM (n1=36) and without T2DM (n2=78) were included. The patients were treated with statin ± anti-diabetic agent. Smokers (> 5 packet-years) and patients with Chronic Kidney Disease (CKD) were excluded. They were under medical supervision in our Lipid, Diabetes and Metabolism Unit for at least 12 months. There were follow-up appointments once every 3 months for the first year and a full lipid profile, HbA1c and BMI were recorded.
Results: After one year under medical supervision, 8% of the diabetics and 31% of the non-diabetics had a totally normal lipid profile. The LDL and the triglyceride (TG) goal in the two groups were achieved by 11% / 46% and 31% / 67% respectively. LDL-C, non-HDL-C and TG achievement rates were higher in non-diabetic patients (p<0.05). 56% of the patients with T2DM achieved HbA1c levels≤ 6,5%.
Conclusion: The statistically significant difference in the lipid control between the diabetics and the non-diabetics is a characteristic of the diabetic dyslipidemia. Intensive medical supervision is of paramount importance for those patients.

Keywords: Lipids, Lipoproteins, Cholesterol, LDL, Diabetes Mellitus, Diabetic Dyslipidemia