Lack of improvement in the treatment of hyperlipidemia among patients with type 2 diabetes

Purpose We investigated the adequacy of treatment of hyperlipidemia in patients with type 2 diabetes, and assessed the temporal trends in adherence to published guidelines. Methods We performed a post hoc analysis of 501 patients enrolled in the Appropriate Blood Pressure Control in Diabetes trial. All patients had fasting lipid profiles at baseline and during the 5 years (1993 to 1998) of the trial. Achieving the National Cholesterol Education Panel’s goals for hyperlipidemia management was the primary outcome. Results The percentage of patients with a low-density lipoprotein (LDL) cholesterol level less than 130 mg/dL was 53% (n = 266) at baseline and 54% (n = 270) at the end of 5 years (P = 0.75). Almost 14% (n = 69) of these patients continued to have an LDL cholesterol level greater than 160 mg/dL at the completion of the study. Only 19% (n = 25) of the 133 patients with known coronary artery disease had an LDL cholesterol level less than 100 mg/dL at baseline, and only 16% (n = 21) achieved this level at the completion of the study (P = 0.37). Conclusion Although prevention of cardiovascular disease in patients with diabetes is a public health priority, our results suggest that hyperlipidemia is being treated suboptimally.