Recent trends in the patterns of dyslipidemia and management strategy in newly diagnosed patients of type 2 diabetes mellitus-2

Authors

  • Dixit Patel Medical Affairs, Intas Pharmaceuticals Limited, Ahmedabad, Gujarat, India
  • Nilanj Dave Medical Affairs, Intas Pharmaceuticals Limited, Ahmedabad, Gujarat, India
  • Vinob Kalkoti Medical Affairs, Intas Pharmaceuticals Limited, Ahmedabad, Gujarat, India
  • Mithilesh Nayak Medical Affairs, Intas Pharmaceuticals Limited, Ahmedabad, Gujarat, India

DOI:

https://doi.org/10.18203/2349-3933.ijam20222978

Keywords:

Diabetes mellitus, Newly diagnosed, Dyslipidemia

Abstract

Background: Objective of the study was to evaluate the patterns of dyslipidaemia in newly diagnosed type 2 diabetes mellitus-2 (T2DM) patients and to understand the initial management options utilised by the treating physician.

Methods: The real world, retrospective, observational REcent trends in the patterns of dyslipidemia and Management strategy in newly diAgnosed Patients of type 2 diabetes mellitus-2 (REMAP-2) study was conducted at various centers including hospitals, clinics, and health care institutes across India between Apr-2021 and Mar-2022. Clinicians at the respective center captured the data in REMAP-2 study data capture form. Dyslipidemia was considered as: total cholesterol >200 mg/dl, low density lipoprotein cholesterol (LDL-C) >100 mg/dl, high density lipoprotein cholesterol (HDL-C) <40 mg/dl, or triglyceride >150 mg/dl.

Results: Of 9605 newly diagnosed T2DM patients with dyslipidemia, 68.94% (n=6622) had mixed dyslipidemia. The mean age was 53.8 years. Majority of the patients were males (63.3%), had family history of diabetes (52.5%), physical activity category of ‘not very active’ or ‘lightly active’ (79.33%), and were overweight or obese (58.9%). About 25.9% of the patients were smokers. Hypertension (72.33%) was the most common comorbidity followed by coronary artery disease (23.44%). The mean glycated hemoglobin (HbA1c) was 8.3%. The most commonly prescribed antidiabetic medication was metformin (87.71%), while lipid lowering therapy was atorvastatin (77.79%).

Conclusions: This study on newly diagnosed T2DM patients with dyslipidemia found that majority of the patients had hypertriglyceridemia, family history of diabetes and were physically inactive. More than half of T2DM patients were either overweight or obese. More than 2/3rd of the patients had mixed dyslipidemia. Statins were prescribed to the majority of these patients and atorvastatin was the most commonly prescribed statin in Indian T2DM patients with dyslipidemia.

References

Laing S, Swerdlow A, Slater S, Burden A, Morris A, Waugh NR et al. Mortality from heart disease in a cohort of 23,000 patients with insulin-treated diabetes. Diabetologia. 2003;46:760-5.

Martín-Timón I, Sevillano-Collantes C, Segura-Galindo A, Del Cañizo-Gómez FJ. Type 2 diabetes and cardiovascular disease: Have all risk factors the same strength? World J Diabetes. 2014;5:444-470.

Collaboration ERF. Diabetes mellitus, fasting blood glucose concentration, and risk of vascular disease: a collaborative meta-analysis of 102 prospective studies. Lancet. 2010;375:2215-22.

Rao Kondapally Seshasai S, Kaptoge S, Thompson A, Di Angelantonio E, Gao P, Sarwar N et al. Diabetes mellitus, fasting glucose, and risk of cause-specific death. N Eng J Med. 2011;364:829-41.

Haffner SM, Stern MP, Hazuda HP, Mitchell BD, Patterson JK. Cardiovascular risk factors in confirmed prediabetic individuals: does the clock for coronary heart disease start ticking before the onset of clinical diabetes? Jama 1990;263:2893-2898.

Sánchez-Bacaicoa C, Galán J, Guijarro C, Rico-Martín S, Monreal M, Calderón-García JF et al. Sustained low-density lipoprotein-cholesterol <70 mg/dl is associated with improved cardiovascular outcomes in the clinical setting. Eur J Clin Invest. 2022;52:e13732.

Mooradian AD. Dyslipidemia in type 2 diabetes mellitus. Nat Clin Pract Endocrinol Metab. 2009;5:150-9.

Jonathan D, Schofield J, Liu Y, Rao-Balakrishna P, Malik R, Soran H. Diabetes dyslipidemia. Diabetes Ther 2016;7:203-19.

Chehade JM, Gladysz M, Mooradian AD. Dyslipidemia in Type 2 Diabetes: Prevalence, Pathophysiology, and Management. Drugs. 2013;73:327-39.

Jacobson TA, Ito MK, Maki KC, Orringer CE, Bays HE, Jones PH et al. National Lipid Association recommendations for patient-centered management of dyslipidemia: part 1–executive summary. Journal of Clin Lipidol. 2014;8:473-88.

Feingold KR. Triglyceride Lowering Drugs. In: Feingold KR, Anawalt B, Boyce A et al. editors. Endotext. South Dartmouth (MA): MDText.com, Inc.; 2000.

Assmann G, Schulte H, von Eckardstein A. Hypertriglyceridemia and elevated lipoprotein (a) are risk factors for major coronary events in middle-aged men. Am J Cardiol. 1996;77:1179-84.

Chapman MJ, Ginsberg HN, Amarenco P, Andreotti F, Borén J, Catapano AL et al. Triglyceride-rich lipoproteins and high-density lipoprotein cholesterol in patients at high risk of cardiovascular disease: evidence and guidance for management. Eur Heart J 2011;32:1345-61.

Mooradian AD. Dyslipidemia in type 2 diabetes mellitus. Nature Rev Endocrinol. 2009;5:150-9.

Mithal A, Majhi D, Shunmugavelu M, Talwarkar PG, Vasnawala H, Raza AS. Prevalence of dyslipidemia in adult Indian diabetic patients: A cross sectional study (SOLID). Indian J Endocrinol Metab. 2014;18:642-7.

Otsuka T, Takada H, Nishiyama Y, Kodani E, Saiki Y, Kato K et al. Dyslipidemia and the Risk of Developing Hypertension in a Working-Age Male Population. J Am Heart Assoc. 2016;5:e003053.

McGill JB, Haffner S, Rees TJ, Sowers JR, Tershakovec AM, Weber M. Progress and controversies: treating obesity and insulin resistance in the context of hypertension. J Clin Hypertension. 2009;11:36-41.

Roderick P, Turner V, Readshaw A, Dogar O, Siddiqi K. The global prevalence of tobacco use in type 2 diabetes mellitus patients: A systematic review and meta-analysis. Diabetes Res Clin Pract. 2019;154:52-65.

Gossett LK, Johnson HM, Piper ME, Fiore MC, Baker TB, Stein JH. Smoking intensity and lipoprotein abnormalities in active smokers. J Clin Lipidol. 2009;3:372-8.

Deo SS, Gore SD, Deobagkar DN, Deobagkar DD. Study of inheritance of diabetes mellitus in Western Indian population by pedigree analysis. J Assoc Physicians India. 2006;54:441-4.

Schofield JD, Liu Y, Rao-Balakrishna P, Malik RA, Soran H. Diabetes Dyslipidemia. Diabetes Ther 2016;7:203-19.

Hulley SB, Rosenman RH, Bawol RD, Brand RJ. Epidemiology as a guide to clinical decisions: the association between triglyceride and coronary heart disease. Eng J Med. 1980;302:1383-9.

Warraich HJ, Wong ND, Rana JS. Role for combination therapy in diabetic dyslipidemia. Curr Cardiol Rep. 2015;17:1-9.

Durrington P, Hyperlipidaemia 3rd edition: diagnosis and management, CRC Press. 2007.

Sjöström L, Lindroos A-K, Peltonen M, Torgerson J, Bouchard C, Carlsson B et al. Lifestyle, diabetes, and cardiovascular risk factors 10 years after bariatric surgery. N Eng J Med. 2004;351:2683-93.

Stumvoll M, Nurjhan N, Perriello G, Dailey G, Gerich JE. Metabolic effects of metformin in non-insulin-dependent diabetes mellitus. N Eng J Med. 1995;333:550-4.

Lin SH, Cheng PC, Tu ST, Hsu SR, Cheng YC, Liu YH. Effect of metformin monotherapy on serum lipid profile in statin-naïve individuals with newly diagnosed type 2 diabetes mellitus: a cohort study. Peer J 2018;6:e4578.

Zhou Q, Liao JK. Statins and cardiovascular diseases: from cholesterol lowering to pleiotropy. Curr Pharmaceutical Design. 2009;15:467-78.

uk MBHPSCGlbcoa. Effects of simvastatin 40 mg daily on muscle and liver adverse effects in a 5-year randomized placebo-controlled trial in 20,536 high-risk people. BMC Clin Pharmacol. 2009;9:1-10.

Preiss D, Seshasai SRK, Welsh P, Murphy SA, Ho JE, Waters DD et al. Risk of incident diabetes with intensive-dose compared with moderate-dose statin therapy: a meta-analysis. JAMA. 2011;305:2556-2564.

Wierzbicki AS. Fibrates: no ACCORD on their use in the treatment of dyslipidaemia. Curr Opin Lipidol. 2010;21:352-8.

Downloads

Published

2022-11-23

Issue

Section

Original Research Articles