Current Status of Low-Density Lipoprotein Cholesterol Target Achievement in Patients with Type 2 Diabetes Mellitus in Korea Compared with Recent Guidelines
- Abstract
- BACKGROUND: We evaluated the achievement of low-density lipoprotein cholesterol (LDL-C) targets in patients with type 2 diabetes mellitus (T2DM) according to up-to-date Korean Diabetes Association (KDA), European Society of Cardiology (ESC)/European Atherosclerosis Society (EAS), and American Diabetes Association (ADA) guidelines. METHODS: This retrospective cohort study collected electronic medical record data from patients with T2DM (≥20 years) managed by endocrinologists from 15 hospitals in Korea (January to December 2019). Patients were categorized according to guidelines to assess LDL-C target achievement. KDA (2019): Very High-I (atherosclerotic cardiovascular disease [ASCVD]) <70 mg/dL; Very High-II (target organ damage [TOD], or cardiovascular risk factors [CVRFs]) <70 mg/dL; high (others) <100 mg/dL. ESC/EAS (2019): Very High-I (ASCVD): <55 mg/dL; Very High-II (TOD or ≥3-CVRF) <55 mg/dL; high (diabetes ≥10 years without TOD plus any CVRF) <70 mg/dL; moderate (diabetes <10 years without CVRF) <100 mg/dL. ADA (2019): Very High-I (ASCVD); Very High-II (age ≥40+ TOD, or any CVRF), for high intensity statin or statin combined with ezetimibe. RESULTS: Among 2,000 T2DM patients (mean age 62.6 years; male 55.9%; mean glycosylated hemoglobin 7.2%) ASCVD prevalence was 24.7%. Of 1,455 (72.8%) patients treated with statins, 73.9% received monotherapy. According to KDA guidelines, LDL-C target achievement rates were 55.2% in Very High-I and 34.9% in Very High-II patients. With ESC/EAS guidelines, target attainment rates were 26.6% in Very High-I, 15.7% in Very High-II, and 25.9% in high risk patients. Based on ADA guidelines, most patients (78.9%) were very-high risk; however, only 15.5% received high-intensity statin or combination therapy. CONCLUSION: According to current dyslipidemia management guidelines, LDL-C goal achievement remains suboptimal in Korean patients with T2DM.
- All Author(s)
- S. J. Yun
; I. K. Jeong
; J. H. Cha
; J. Lee
; H. C. Cho
; S. H. Choi
; S. Chun
; H. J. Jeon
; H. C. Kang
; S. S. Kim
; S. H. Ko
; G. Koh
; S. K. Kwon
; J. H. Lee
; M. K. Moon
; J. Noh
; C. Y. Park
; S. Kim
- Issued Date
- 2021
- Type
- Article
- Keyword
- Cholesterol, LDL; Diabetes mellitus, type 2; Dyslipidemias; Guideline; Hydroxymethylglutaryl-CoA reductase inhibitors
- Publisher
- 대한당뇨병학회
- ISSN
- 2233-6079
- Citation Title
- Diabetes & Metabolism Journal
- Citation Volume
- 46
- Citation Number
- 3
- Citation Start Page
- 464
- Citation End Page
- 475
- Language(ISO)
- eng
- DOI
- 10.4093/dmj.2021.0088
- URI
- http://schca-ir.schmc.ac.kr/handle/2022.oak/1881
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